Telephone versus internet administration of self-report measures of social anxiety, depressive symptoms, and insomnia: psychometric evaluation of a method to reduce the impact of missing data.

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Hedman, Erik; Ljótsson, Brjánn; Blom, Kerstin; El Alaoui, Samir; Kraepelien, Martin; Rück, Christian; Andersson, Gerhard; Svanborg, Cecilia; Lindefors, Nils; Kaldo, Viktor

2013-10-18

Internet-administered self-report measures of social anxiety, depressive symptoms, and sleep difficulties are widely used in clinical trials and in clinical routine care, but data loss is a common problem that could render skewed estimates of symptom levels and treatment effects. One way of reducing the negative impact of missing data could be to use telephone administration of self-report measures as a means to complete the data missing from the online data collection. The aim of the study was to compare the convergence of telephone and Internet administration of self-report measures of social anxiety, depressive symptoms, and sleep difficulties. The Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR), Montgomery-Åsberg Depression Rating Scale-Self-Rated (MADRS-S), and the Insomnia Severity Index (ISI) were administered over the telephone and via the Internet to a clinical sample (N=82) of psychiatric patients at a clinic specializing in Internet-delivered treatment. Shortened versions of the LSAS-SR and the ISI were used when administered via telephone. As predicted, the results showed that the estimates produced by the two administration formats were highly correlated (r=.82-.91; PInternet: Cronbach alpha=.79-.93). The correlation coefficients were similar across questionnaires and the shorter versions of the questionnaires used in the telephone administration of the LSAS-SR and ISI performed in general equally well compared to when the full scale was used, as was the case with the MADRS-S. Telephone administration of self-report questionnaires is a valid method that can be used to reduce data loss in routine psychiatric practice as well as in clinical trials, thereby contributing to more accurate symptom estimates.

Clinical preference for factors in treatment of geriatric depression

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Riepe MW

2014-12-01

Full Text Available Matthias W Riepe Mental Health and Geriatric Psychiatry, Psychiatry II, Ulm University, Ulm, Germany Abstract: Little is known about symptom preferences of clinical psychiatrists in the treatment of geriatric depression and preferences for avoiding adverse drug effects. Participants (board-certified psychiatrists were recruited prior to a lecture on geriatric depression during a continuing education program. An analytic hierarchy process was performed and participants were asked for pairwise comparison of criteria guiding them in appraising therapeutic efficacy, and in avoiding toxicity and adverse events. Of the 61 participants from the continuing education program, 42 (69% returned their data sheet. Avoidance of cardiotoxicity was regarded as more important than avoidance of hepatotoxicity or hematotoxicity. Concerning adverse events, highest preference was given to avoidance of falls and drug interactions, followed by avoidance of sedation, weight change, and impairment of sexual function. The most important preferences for appraisal of therapeutic efficacy were suicidality over ability to concentrate and sleep. Clinical psychiatrists have a hierarchy of preferences for treatment goals and avoidance of adverse events and toxicity. This raises the question for future research whether these preferences cause differences in prescription patterns in clinical practice even though a multitude of antidepressants are similarly effective when judged with instruments used in clinical trials. Keywords: depressive disorder, symptoms, analytic hierarchy process, toxicity, adverse events, symptoms

Artificial Neural Network (ANN) Model to Predict Depression among Geriatric Population at a Slum in Kolkata, India.

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Sau, Arkaprabha; Bhakta, Ishita

2017-05-01

Depression is one of the most important causes of mortality and morbidity among the geriatric population. Although, the aging brain is more vulnerable to depression, it cannot be considered as physiological and an inevitable part of ageing. Various sociodemographic and morbidity factors are responsible for the depression among them. Using Artificial Neural Network (ANN) model depression can be predicted from various sociodemographic variables and co morbid conditions even at community level by the grass root level health care workers. To predict depression among geriatric population from sociodemographic and morbidity attributes using ANN. An observational descriptive study with cross-sectional design was carried out at a slum under the service area of Bagbazar Urban Health and Training Centre (UHTC) in Kolkata. Among 126 elderlies under Bagbazar UHTC, 105 were interviewed using predesigned and pretested schedule. Depression status was assessed using 30 item Geriatric Depression Scale. WEKA 3.8.0 was used to develop the ANN model and test its performance. Prevalence of depression among the study population was 45.7%. Various sociodemographic variables like age, gender, literacy, living spouse, working status, personal income, family type, substance abuse and co morbid conditions like visual problem, mobility problem, hearing problem and sleeping problem were taken into consideration to develop the model. Prediction accuracy of this ANN model was 97.2%. Depression among geriatric population can be predicted accurately using ANN model from sociodemographic and morbidity attributes.

Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial.

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Louise Farrer

Full Text Available BACKGROUND: Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. AIM: To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. METHOD: 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. RESULTS: Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. CONCLUSIONS: A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. TRIAL REGISTRATION: Controlled-Trials.comISRCTN93903959.

Prevalence and predictors of depression and anxiety among the elderly population living in geriatric homes in Cairo, Egypt.

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Ahmed, Dalia; El Shair, Inas Helmi; Taher, Eman; Zyada, Fadia

2014-12-01

Anxiety and depression are common in the elderly and affect their quality of life. The rates of depression and anxiety are higher among those living in institutional settings and are usually undiagnosed. The aim of the study was to determine the prevalence and predictors of depression, anxiety and mixed form (i.e. depression and anxiety) in the elderly living at geriatric homes. A cross-sectional study was conducted on 240 elderly participants from four randomly selected geriatric homes in Cairo. A pretested interview questionnaire was used to collect data. A short version of the Geriatric Depression Scale (GDS-15), the Hamilton Anxiety Scale, the Katz scale for Activity of Daily living, the three-item loneliness scale and the Personal Wellbeing Index Scale were used. The prevalence of depression, anxiety and mixed disorder among the studied group were 37.5, 14.2 and 30%, respectively. Old age and the presence of comorbidities were predictors for depression and/or anxiety. Female sex, a lower social class, insufficient income, partial independence and loneliness feeling are significant predictors for depression. Being married and loneliness feeling are significant predictors for anxiety, whereas the functional status is a significant predictor for mixed depression and anxiety. Depression and/or anxiety were found in more than 80% of the studied group. An older age, female sex, insufficient income, a lower social class, a partially independent functional status, the presence of comorbidities, more frequent loneliness feeling and being married or divorced were found to be significant predictors for these problems. This study reflects the need for the screening of the elderly in geriatric homes for depression and/or anxiety, especially among high-risk groups, and developing interventions to prevent and control such problems.

Quality of Life and Spiritual Well-Being in Geriatric Patients With Chronic Depression

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Izadmehr

2014-08-01

Full Text Available Background Most people do not appreciate the aging period because of lack of knowledge or unknown backgrounds; therefore, they get affected by chronic mental disorders. Depression is one of the most predominant chronic mental disorders. Objectives In this study, we aimed to examine the relationship between quality of life (QOL and spiritual well-being among geriatric retired employees of the oil industry in Khuzestan, Iran, who had chronic depression. Patients and Methods This was a cross-sectional study on 200 retired employees of the oil industry in Khuzestan, Iran, selected using simple random sampling technique. The variables were measured by three different standard questionnaires, including the QOL questionnaire (SF12, spiritual well-being scale (SWB, and depression scale (GDS. Results The mean age of the study group was 65 ± 4 years. Most of the patients had elementary or middle school level of education (44%. Hypertension was the predominant chronic disease associated with depression (37%. The mean QOL, spiritual well-being, and depression scores were 27.9 ± 6.4, 105 ± 13.8, and 4.2 ± 4.35, respectively. Spiritual well-being had a significant negative correlation with depression (P = 0.0001, indicating that the prevalence of chronic diseases such as depression decreased as spiritual well-being increased. There was also a significant negative correlation between the QOL and depression (P = 0.0001. Conclusions The results of our study showed that chronic depression disorder was significantly correlated with QOL and spiritual well-being of the elderly. To have healthy, independent, and happy geriatrics, it is important to consider such problems.

The Factor Structure for the Geriatric Depression Scale in Screening Depression in Taiwanese Patients with Very Mild to Moderate Dementia

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Huang, Si-Sheng; Liao, Yi-Cheng; Wang, Wen-Fu

2017-01-01

Background: To define the factor structures of the 30 items Geriatric Depression Scale (GDS-30) when assessing the depression in patients with very mild to moderate dementia. Methods: A total of 240 pairs of patients with very mild to moderate dementia and their caregivers who visited the memory clinic of the medical center in Taiwan from July 2001 to October 2008 were surveyed. The depression of patients with dementia was evaluated using the Chinese version of the GDS-30. We analyzed the ...

A literature review of the application of the Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist to community nursing cohorts.

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Allen, Jacqui; Annells, Merilyn

2009-04-01

To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post-traumatic stress disorder. War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post-traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so. The use of valid and reliable self-report tools is one method of improving nurses' identification of people with actual or potential mental health difficulties for referral to a general practitioner or mental health practitioner for diagnostic assessment and treatment. The Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist are frequently recommended for mental health screening but the appropriateness of using the tools for screening war veteran and war widow(er) community nursing clients who are often aged and have functional impairment, is unknown. Systematic review. Current literature informs that the Geriatric Depression Scale accurately predicts a diagnosis of depression in community nursing cohorts. The three Depression Anxiety Stress Scales subscales of depression, anxiety and stress are valid; however, no studies were identified that compared the performance of the Depression Anxiety Stress Scales in predicting diagnoses of depression or anxiety. The Post-traumatic Stress Disorder Checklist predicts post-traumatic stress disorder in community cohorts although no studies meeting the selection criteria included male participants. This review provides recommendations for the use of the Geriatric Depression Scale, Depression Anxiety Stress Scales and The Post-traumatic Stress Disorder Checklist based on examination of the published evidence for the application of these screening tools in samples

Effects of Pride and Regret on Geriatric Depression: A Cross-Cultural Study With Mixed-Methods Approaches.

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Lee, Othelia E; Ryu, Seungah

2018-03-01

Pride and regret are self-conscious emotions that develop later in life and become a source of emotional struggle. This cross-cultural study examined the effect of the content and intensity of self-conscious emotions on Geriatric Depression Scale (GDS) scores. Among a convenience sample of 234 older adults (130 in the United States and 104 in South Korea), the contents and intensities of both life regrets and pride were examined. Although a greater variety of regrets was cited by Americans, overall Korean respondents reported higher intensity of regret. Regrets that were related to leisure and addiction among Americans and health and career among Koreans were predictors of the GDS scores. Pride in leisure activities for Americans and altruism among Koreans could alleviate depression. While regrets and pride explained a small amount of the variance in the GDS scores, current life stressors greatly contributed to geriatric depression.

The effect of telephone support on depressive symptoms among HIV-infected pregnant women in Thailand: an embedded mixed methods study.

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Ross, Ratchneewan; Sawatphanit, Wilaiphan; Suwansujarid, Tatirat; Stidham, Andrea W; Drew, Barbara L; Creswell, John W

2013-01-01

Depressive symptoms negatively impact the lives of HIV-infected individuals and are correlated with faster progression to AIDS. Our embedded mixed methods study examined and described the effects of telephone support on depressive symptoms in a sample of HIV-infected pregnant Thai women. HIV-infected pregnant Thai women (n = 40) were randomly assigned to either the control or the intervention group. A registered nurse provided telephone support to the intervention group. Depressive symptoms were measured at three points in both groups. In-depth interviews were conducted at Time 2 and Time 3. Results show that depressive symptoms in the intervention group decreased over time. Qualitative results describe how telephone support can work, but also reveal that telephone support did not work for everyone. We recommend that a larger mixed methods study be conducted to examine the effects of telephone support on depressive symptoms among HIV-infected women, including the costs and benefits of such support. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Telephone-based physical activity counseling for major depression in people with multiple sclerosis.

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Bombardier, Charles H; Ehde, Dawn M; Gibbons, Laura E; Wadhwani, Roini; Sullivan, Mark D; Rosenberg, Dori E; Kraft, George H

2013-02-01

Physical activity represents a promising treatment for major depressive disorder (MDD) in people with multiple sclerosis (MS). We conducted a single-blind, two-arm randomized controlled trial comparing a 12-week physical activity counseling intervention delivered primarily by telephone (n = 44) to a wait-list control group (N = 48). Ninety-two adults with MS and MDD or dysthymia (M(age) = 48 years; 86% female, 92% White) completed an in-person baseline assessment and were randomized to wait-list control or an intervention involving motivational-interviewing-based promotion of physical activity. The treatment group received an initial in-person session; 7 telephone counseling sessions (Weeks 1, 2, 3, 4, 6, 8, and 10), and an in-person session at Week 12. The primary outcome, treatment response, was defined as those with 50% or greater reduction in the Hamilton Depression Rating Scale (HAM-D) score. Our primary hypothesis, that the proportion of responders in the treatment group would be significantly greater than in the control group, was not confirmed. However, compared with the control group, those in the treatment group evidenced significantly lower depression severity on the HAM-D, on self-reported depression, and on a measure of potential side effects and at 12 weeks were less likely to meet the criteria for MDD as set forth in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Physical activity increased significantly more in the treatment condition, though it did not mediate improvement in depression severity. Telephone-based physical activity promotion represents a promising approach to treating MDD in MS. Further research is warranted on ways to bolster the impact of the intervention and on mediators of the treatment effect.

The Effects of Donepezil on 15-Item Geriatric Depression Scale Structure in Patients with Alzheimer Disease

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Youngsoon Yang

2016-09-01

Full Text Available Background/Aims: In Alzheimer disease (AD, depression is among the most common accompanying neuropsychiatric symptoms and has different clinical manifestations when compared with early-life depression. In patients with drug-naïve AD, we tried to explore the structure of the 15-item Geriatric Depression Scale (GDS15 and the effect of donepezil on these substructures. Methods: GDS15, cognitive function, and activities of daily living function tests were administered to 412 patients with probable AD who had not been medicated before visiting the hospital. Using principal component analysis, three factors were identified. The patients with AD who received only donepezil were retrospectively analyzed and we compared the change of cognition and GDS15 subgroup after donepezil medication. Results: Our study identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale. The Barthel index was significantly correlated with factor 1 (positively and factor 2 (negatively. The Korean version of the MMSE (K-MMSE was significantly correlated with factor 2 and factor 3. Compared to the baseline state, K-MMSE and GDS15 showed significant improvement after taking donepezil. Among GDS15 subgroups, factor 2 and factor 3 showed significant improvement after donepezil treatment. Conclusions: These results suggest that the GDS15 may be comprised of a heterogeneous scale and donepezil differentially affects the GDS15 subgroup in AD.

Study protocol for a randomized controlled trial of telephone-delivered cognitive behavior therapy compared with befriending for treating depression and anxiety in older adults with COPD

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Doyle C

2016-02-01

Full Text Available Colleen Doyle,1 David Dunt,2 David Ames,3 Marcia Fearn,3 Emily (Chuanmei You,1 Sunil Bhar41Australian Catholic University, Melbourne, VIC, Australia; 2Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia; 3National Ageing Research Institute, Melbourne, VIC, Australia; 4Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, AustraliaBackground: COPD is an umbrella term to describe chronic lung diseases that cause limitations in lung airflow, including emphysema and chronic bronchitis. The prevalence of depression and anxiety in people with COPD is high, although these comorbidities are often undiagnosed, untreated, or undertreated. There is a need to identify efficacious treatments for depression and anxiety in people with COPD. Cognitive behavior therapy (CBT for the treatment of anxiety and depression has a strong evidence base. There has been some success delivering this treatment over the telephone in limited studies. The aim of this study is to evaluate the efficacy of both telephone-administered CBT and befriending on outcomes for patients with diagnosed COPD who have at least mild levels of depression and/or anxiety.Methods: The protocol described in this paper is of a pragmatic randomized controlled trial comparing eight sessions of telephone CBT to an active social control, referred to as befriending. Primary outcome measures will include depression and anxiety symptoms, and secondary outcome measures will include quality of life, self-efficacy, and COPD symptom severity. Participants’ satisfaction with the intervention and therapeutic alliance will also be assessed. Measures will be taken pre- and postdelivery of the intervention and again at 8 weeks following the intervention.Conclusion: People with COPD often have limitations to their mobility because of their breathlessness. They are often already attending many medical appointments and could be reluctant to attend for

Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

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Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

2005-01-01

Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

NARCIS (Netherlands)

Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

Validation of the Tamil version of short form Geriatric Depression Scale-15.

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Sarkar, Sonali; Kattimani, Shivananand; Roy, Gautam; Premarajan, K C; Sarkar, Siddharth

2015-01-01

Local language screening instruments can be helpful in early assessment of depression in the elderly in the community and primary care population. This study describes the validation of a Tamil version of Geriatric Depression Scale (short form 15 [GDS-15] item) in a rural population. A Tamil version of GDS-15 was developed using standardized procedures. The questionnaire was applied in a sample of elderly (aged 60 years and above) from a village in South India. All the participants were also assessed for depression by a clinical interview by a psychiatrist. A total of 242 participants were enrolled, 64.9% of them being females. The mean score on GDS-15 was 7.4 (±3.4), while the point prevalence of depression was 6.2% by clinical interview. The area under the receiver-operator curve was 0.659. The optimal cut-off for the GDS in this sample was found at 7/8 with sensitivity and specificity being 80% and 47.6%, respectively. The Tamil version of GDS-15 can be a useful screening instrument for assessment of depression in the elderly population.

Polypharmacy as a risk factor for depressive symptoms in geriatric patients: an observational, cross-sectional study

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Spandel Leszek

Full Text Available Aim: The aim of this study was to investigate the correlation between polypharmacy and depressive symptoms in hospitalized adults aged over 65 years. Patients and methods: We obtained medical history and current treatment data from clinical records. We used the Abbreviated Mental Test Score (AMTS to exclude patients with dementia. The Geriatric Depression Scale (GDS was used assess depressive symptoms. Pearson and Spearman coefficients were used to determine the relationship between variables. Results: A total of 206 individuals were included. The average number of medications taken by the individuals was 6.9 ± 2.7 and the average GDS score was 4.9 ± 3.4 points. Depressive symptoms (GDS score >5 points were observed in 68 (33.0% individuals. GDS score positively correlated with the number of medications used (R = 0.74; P = 0.0001, the number of chronic conditions (R = 0.78; P = 0.001, and pain complaints (Z = 7.94; P = 0.0001. A significant association between GDS score and the use of the following medications was observed: statins, cytostatic agents, corticosteroids, benzodiazepines, cardiac glycosides, non-steroidal anti-inflammatory drugs, muscle relaxants, non-psychotropic drugs with anticholinergic properties, and centrally acting analgesics (all P < 0.05. Conclusions: Our study indicates that polypharmacy is positively correlated with the presence of depressive symptoms in geriatric patients. We identified a number of medications associated with a higher prevalence of depressive symptoms, however these relationships require further examination.

Older adults display concurrent but not delayed associations between life stressors and depressive symptoms: a microlongitudinal study.

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Dautovich, Natalie D; Dzierzewski, Joseph M; Gum, Amber M

2014-11-01

The present study investigated the temporal association between life event stressors relevant to older adults and depressive symptoms using a micro-longitudinal design (i.e., monthly increments over a six-month period). Existing research on stress and depressive symptoms has not examined this association over shorter time periods (e.g., monthly), over multiple time increments, or within-persons. An in-person initial interview was followed by six monthly interviews conducted by telephone. Community. Data were drawn from a study of 144 community-dwelling older adults with depressive symptoms. Stressful life events were measured using the Geriatric Life Events Scale (GALES), and depressive symptoms were assessed with the Short - Geriatric Depression Scale (S-GDS). Using multilevel modeling, 31% of the S-GDS' and 39% of the GALES' overall variance was due to within-person variability. Females and persons with worse health reported more depressive symptoms. Stressful life events predicted concurrent depressive symptoms, but not depressive symptoms one month later. The lack of a time-lagged relationship suggests that older adults with depressive symptoms may recover more quickly from life stressors than previously thought, although additional research using varying time frames is needed to pinpoint the timing of this recovery as well as to identify older adults at risk of long-term effects of life stressors. Copyright © 2014 American Association for Geriatric Psychiatry. All rights reserved.

Protocol for a randomized controlled dismantling study of a brief telephonic psychological intervention applied to non-professional caregivers with symptoms of depression.

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Vázquez, Fernando L; Torres, Ángela; Díaz, Olga; Otero, Patricia; Blanco, Vanessa; Hermida, Elisabet

2015-11-23

Although depression is a common problem in caregivers and there are effective cognitive-behavioral interventions for its prevention, the ability of caregivers to attend these treatments is often limited by logistics. Furthermore, the efficacy of the components of these interventions is unknown. The objectives of this study are to (a) evaluate the efficacy of a telephone-administered cognitive-behavioral intervention to prevent depression with all its components (cognitive and behavioral) and only with behavioral activation, and to (b) analyze the mediators of the change in depressive symptoms. A randomized controlled clinical trial was designed to dismantle the components of a cognitive-behavioral intervention. Caregivers with elevated depressive symptoms will be randomly assigned to a cognitive-behavioral intervention, an intervention with only the behavioral activation component, or a usual care control group. Each condition will consist of approximately 60 participants. The two interventions will consist of five sessions lasting 90 min each, applied to groups of about 5 participants at a time via conference call. Trained interviewers, blind to the experimental conditions, will conduct the assessments at the pre-treatment, post-treatment and 1-, 3-, 6- and 12-month follow-ups. This study will provide evidence of the efficacy of a cognitive-behavioral intervention to prevent depression in caregivers with elevated depressive symptoms administered via conference call, and on the impact of the behavioral activation component on the overall efficacy of the program. If we find favorable results, it would mean that we have developed a program of prevention of depression of higher clinical utility and efficacy than those currently available, which would make it possible for a large number of caregivers to have access to such resources. ClinicalTrials.gov: NCT02292394. Registered 6 November 2014.

Telephone-Based Physical Activity Counseling for Major Depression in People with Multiple Sclerosis

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Bombardier, Charles H.; Ehde, Dawn M.; Gibbons, Laura E.; Wadhwani, Roini; Sullivan, Mark D.; Rosenberg, Dori E.; Kraft, George H.

2013-01-01

Objective: Physical activity represents a promising treatment for major depressive disorder (MDD) in people with multiple sclerosis (MS). We conducted a single-blind, two-arm randomized controlled trial comparing a 12-week physical activity counseling intervention delivered primarily by telephone (n = 44) to a wait-list control group (N = 48).…

Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial.

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Furukawa, Toshi A; Horikoshi, Masaru; Kawakami, Norito; Kadota, Masayo; Sasaki, Megumi; Sekiya, Yuki; Hosogoshi, Hiroki; Kashimura, Masami; Asano, Kenichi; Terashima, Hitomi; Iwasa, Kazunori; Nagasaku, Minoru; Grothaus, Louis C

2012-01-01

Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism). We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT). We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP) versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan. The primary outcomes were depression severity as measured with Beck Depression Inventory-II (BDI-II) and presenteeism as measured with World Health Organization Health and Work Productivity Questionnaire (HPQ). In the course of the trial the follow-up period was shortened in order to increase acceptability of the study. The planned sample size was 108 per arm but the trial was stopped early due to low accrual. Altogether 118 subjects were randomized to tCBT+EAP (n = 58) and to EAP alone (n = 60). The BDI-II scores fell from the mean of 17.3 at baseline to 11.0 in the intervention group and to 15.7 in the control group after 4 months (p<0.001, Effect size = 0.69, 95%CI: 0.32 to 1.05). However, there was no statistically significant decrease in absolute and relative presenteeism (p = 0.44, ES = 0.15, -0.21 to 0.52, and p = 0.50, ES = 0.02, -0.34 to 0.39, respectively). Remote CBT, including tCBT, may provide easy access to quality-assured effective psychotherapy for people in the work force who present with subthreshold depression. Further studies are needed to evaluate the effectiveness of this approach in longer terms. The study was funded by Sekisui Chemicals Co. Ltd. ClinicalTrials.gov NCT00885014.

Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial.

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Toshi A Furukawa

Full Text Available Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism. We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT.We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan. The primary outcomes were depression severity as measured with Beck Depression Inventory-II (BDI-II and presenteeism as measured with World Health Organization Health and Work Productivity Questionnaire (HPQ. In the course of the trial the follow-up period was shortened in order to increase acceptability of the study.The planned sample size was 108 per arm but the trial was stopped early due to low accrual. Altogether 118 subjects were randomized to tCBT+EAP (n = 58 and to EAP alone (n = 60. The BDI-II scores fell from the mean of 17.3 at baseline to 11.0 in the intervention group and to 15.7 in the control group after 4 months (p<0.001, Effect size = 0.69, 95%CI: 0.32 to 1.05. However, there was no statistically significant decrease in absolute and relative presenteeism (p = 0.44, ES = 0.15, -0.21 to 0.52, and p = 0.50, ES = 0.02, -0.34 to 0.39, respectively.Remote CBT, including tCBT, may provide easy access to quality-assured effective psychotherapy for people in the work force who present with subthreshold depression. Further studies are needed to evaluate the effectiveness of this approach in longer terms. The study was funded by Sekisui Chemicals Co. Ltd.ClinicalTrials.gov NCT00885014.

Telephone Cognitive-Behavioral Therapy for Subthreshold Depression and Presenteeism in Workplace: A Randomized Controlled Trial

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Furukawa, Toshi A.; Horikoshi, Masaru; Kawakami, Norito; Kadota, Masayo; Sasaki, Megumi; Sekiya, Yuki; Hosogoshi, Hiroki; Kashimura, Masami; Asano, Kenichi; Terashima, Hitomi; Iwasa, Kazunori; Nagasaku, Minoru; Grothaus, Louis C.

2012-01-01

Background Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism). We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT). Methods We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP) versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan. The primary outcomes were depression severity as measured with Beck Depression Inventory-II (BDI-II) and presenteeism as measured with World Health Organization Health and Work Productivity Questionnaire (HPQ). In the course of the trial the follow-up period was shortened in order to increase acceptability of the study. Results The planned sample size was 108 per arm but the trial was stopped early due to low accrual. Altogether 118 subjects were randomized to tCBT+EAP (n = 58) and to EAP alone (n = 60). The BDI-II scores fell from the mean of 17.3 at baseline to 11.0 in the intervention group and to 15.7 in the control group after 4 months (p<0.001, Effect size = 0.69, 95%CI: 0.32 to 1.05). However, there was no statistically significant decrease in absolute and relative presenteeism (p = 0.44, ES = 0.15, −0.21 to 0.52, and p = 0.50, ES = 0.02, −0.34 to 0.39, respectively). Conclusion Remote CBT, including tCBT, may provide easy access to quality-assured effective psychotherapy for people in the work force who present with subthreshold depression. Further studies are needed to evaluate the effectiveness of this approach in longer terms. The study was funded by Sekisui Chemicals Co. Ltd. Trial Registration ClinicalTrials.gov NCT00885014 PMID:22532849

Anosognosia and depression in patients with Alzheimer's dementia.

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Verhülsdonk, Sandra; Quack, Robin; Höft, Barbara; Lange-Asschenfeldt, Christian; Supprian, Tillmann

2013-01-01

Anosognosia refers to impaired awareness of patients to realize deficits related to a disorder and is a common symptom of dementia. Anosognosia has far-reaching consequences for diagnosis and treatment and is probably associated with unfavorable prognosis. This study examined the relationship between anosognosia and depression in patients with Alzheimer's dementia (AD). Assessment included interviews of patients and their caregivers. Depressive symptoms were evaluated with observer and self-rating instruments: the Geriatric Depression Scale (GDS), and the "mood" subscale of the Nurses Observation Scale for geriatric patients (NOSGER). Anosognosia was evaluated with the Anosognosia Questionnaire for Dementia (AQ-D). For the evaluation of behavioral and neuropsychological symptoms in dementia and the caregiver burden, the neuropsychiatric inventory (NPI) and the Cares of older People in Europe (COPE) Index were administered. A total of 47 patients were enrolled in the study at the department's geriatric psychiatry outpatient clinic. A considerable discrepancy was found between observer- and self-ratings of depressive symptoms. In 74.5% of the participants, caregiver ratings indicated secondary symptoms of depression as opposed to patient ratings. Thus, in AD, anosognosia may affect not only deficits in cognition and everyday functioning but also affective symptoms ("affective anosognosia"). Caregiver rating therefore is particularly important when assessing mood changes in AD patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study.

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Yi, Sang-Wook

2016-05-01

Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; pdepression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; psuicide deaths was 0.61 (95% CI, 0.58 to 0.64). Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

The effect of telephone-based interpersonal psychotherapy for the treatment of postpartum depression: study protocol for a randomized controlled trial

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Dennis Cindy-Lee

2012-04-01

Full Text Available Abstract Background Substantial data indicate potential health consequences of untreated postpartum depression (PPD on the mother, infant, and family. Studies have evaluated interpersonal psychotherapy (IPT as treatment for PPD; however, the results are questionable due to methodological limitations. A comprehensive review of maternal treatment preferences suggests that mothers favor ‘talking therapy’ as a form of PPD treatment. Unfortunately, IPT is not widely available, especially in rural and remote areas. To improve access to care, telepsychiatry has been introduced, including the provision of therapy via the telephone. Methods/Design The purpose of this randomized controlled trial is to evaluate the effect of telephone-based IPT on the treatment of PPD. Stratification is based on self-reported history of depression and province. The target sample is 240 women. Currently, women from across Canada between 2 and 24 weeks postpartum are able to either self-identify as depressed and refer themselves to the trial or they may be referred by a health professional based on a score >12 on the Edinburgh Postnatal Depression Scale (EPDS. Following contact by the trial coordinator, a detailed study explanation is provided. Women who fulfill the eligibility criteria (including a positive diagnostic assessment for major depression and consent to participate are randomized to either the control group (standard postpartum care or intervention group (standard postpartum care plus 12 telephone-based IPT sessions within 12 to 16 weeks, provided by trained nurses. Blinded research nurses telephone participants at 12, 24, and 36 weeks post-randomization to assess for PPD and other outcomes including depressive symptomatology, anxiety, couple adjustment, attachment, and health service utilization. Results from this ongoing trial will: (1 develop the body of knowledge concerning the effect of telephone-based IPT as a treatment option for PPD; (2 advance our

Psychosocial Issues in Geriatric Rehabilitation.

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Rodriguez, Ricardo M

2017-11-01

Geriatric patients present multiple age-related challenges and needs that must be taken into account during the rehabilitation process to achieve expected goals. This article examines the importance of identifying and managing psychosocial issues commonly observed in older adults and presents strategies to optimize their rehabilitation process. Depression, anxiety, fear of falling, adjustment issues, neurocognitive disorders, and caregiver support are discussed as a selection of factors that are relevant for geriatric patients undergoing rehabilitation. An argument is made for the importance of comprehensive geriatric assessment in older adults to identify salient issues that may impact rehabilitation and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study

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Sang-Wook Yi

2016-05-01

Full Text Available Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years. More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001. The unadjusted hazard ratios (HRs in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001 than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001. The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64. Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Comprehensive Geriatric Assessment (CGA in general practice: Results from a pilot study in Vorarlberg, Austria

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Mann Eva

2004-05-01

Full Text Available Abstract Background Most comprehensive geriatric assessment (CGA programs refer to hospital-based settings. However the body of geriatric healthcare is provided by general practitioners in their office. Structured geriatric problem detection by means of assessment instruments is crucial for efficient geriatric care giving in the community. Methods We developed and pilot tested a German language geriatric assessment instrument adapted for general practice. Nine general practices in a rural region of Austria participated in this cross-sectional study and consecutively enrolled 115 persons aged over 75 years. The prevalence of specific geriatric problems was assessed, as well as the frequency of initiated procedures following positive and negative tests. Whether findings were new to the physician was studied exemplarily for the items visual and hearing impairment and depression. The acceptability was recorded by means of self-administered questionnaires. Results On average, each patient reported 6.4 of 14 possible geriatric problems and further consequences resulted in 43.7% (27.5% to 59.8% of each problem. The items with either the highest prevalence and/or the highest number of initiated actions by the GPs were osteoporosis risk, urinary incontinence, decreased hearing acuity, missing pneumococcal vaccination and fall risk. Visual impairment was newly detected in only 18% whereas hearing impairment and depression was new to the physician in 74.1% and 76.5%, respectively. A substantial number of interventions were initiated not only following positive tests (43.7% per item; 95% CI 27.5% to 59.8%, but also as a consequence of negative test results (11.3% per item; 95% CI 1.7% to 20.9%. The mean time expenditure to accomplish the assessment was 31 minutes (SD 10 min. Patients (89% and all physicians confirmed the CGA to provide new information in general on the patient's health status. All physicians judged the CGA to be feasible in everyday

Geriatric Syndromes in Hospitalized Older Adults Discharged to Skilled Nursing Facilities

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Bell, Susan P.; Vasilevskis, Eduard E.; Saraf, Avantika A.; Jacobsen, J. Mary Lou; Kripalani, Sunil; Mixon, Amanda S.; Schnelle, John F.; Simmons, Sandra F.

2016-01-01

Background Geriatric syndromes are common in older adults and associated with adverse outcomes. The prevalence, recognition, co-occurrence and recent onset of geriatric syndromes in patients transferred from hospital to skilled nursing facilities (SNFs) are largely unknown. Design Quality improvement project. Setting Acute care academic medical center and 23 regional partner SNFs. Participants 686 Medicare beneficiaries hospitalized between January 2013 and April 2014 and referred to SNFs. Measurements Nine geriatric syndromes were measured by project staff -- weight loss, decreased appetite, incontinence and pain (standardized interview), depression (Geriatric Depression Scale), delirium (Brief-Confusion Assessment Method), cognitive impairment (Brief Interview for Mental Status), falls and pressure ulcers (hospital medical record utilizing hospital-implemented screening tools). Estimated prevalence, new-onset prevalence and common coexisting clusters were determined. The extent that syndromes were commonly recognized by treating physicians and communicated to SNFs in hospital discharge documentation was evaluated. Results Geriatric syndromes were prevalent in more than 90% of hospitalized adults referred to SNFs; 55% met criteria for 3 or more co-existing syndromes. Overall the most prevalent syndromes were falls (39%), incontinence (39%), decreased appetite (37%) and weight loss (33%). Of individuals that met criteria for 3 or more syndromes, the most common triad clusters included nutritional syndromes (weight loss, loss of appetite), incontinence and depression. Treating hospital physicians commonly did not recognize and document geriatric syndromes in discharge summaries, missing 33–95% of syndromes present as assessed by research personnel. Conclusion Geriatric syndromes in hospitalized older adults transferred to SNF are prevalent and commonly co-exist with the most frequent clusters including nutritional syndromes, depression and incontinence. Despite

Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.

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Kargar Jahromi, Marzieh; Javadpour, Shohreh; Taheri, Leila; Poorgholami, Farzad

2015-07-26

Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.

Stressful life events, perceived stress, and 12-month course of geriatric depression: direct effects and moderation by the 5-HTTLPR and COMT Val158Met polymorphisms.

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Zannas, Anthony S; McQuoid, Douglas R; Steffens, David C; Chrousos, George P; Taylor, Warren D

2012-07-01

Although the relation between stressful life events (SLEs) and risk of major depressive disorder is well established, important questions remain about the effects of stress on the course of geriatric depression. Our objectives were (1) to examine how baseline stress and change in stress is associated with course of geriatric depression and (2) to test whether polymorphisms of serotonin transporter (5-HTTLPR) and catechol-O-methyltransferase (COMT Val158Met) genes moderate this relation. Two-hundred and sixteen depressed subjects aged 60 years or older were categorized by remission status (Montgomery-Asberg depression rating scale≤6) at 6 and 12 months. At 6 months, greater baseline numbers of self-reported negative and total SLEs and greater baseline perceived stress severity were associated with lower odds of remission. At 12 months, only baseline perceived stress predicted remission. When we examined change in stress, 12-month decrease in negative SLEs and level of perceived stress were associated with improved odds of 12-month remission. When genotype data were included, COMT Val158Met genotype did not influence these relations. However, when compared with 5-HTTLPR L/L homozygotes, S allele carriers with greater baseline numbers of negative SLEs and with greater decrease in negative SLEs were more likely to remit at 12 months. This study demonstrates that baseline SLEs and perceived stress severity may influence the 12-month course of geriatric depression. Moreover, changes in these stress measures over time correlate with depression outcomes. 5-HTTLPR S carriers appear to be more susceptible to both the effects of enduring stress and the benefit of interval stress reduction.

Mums 4 Mums: structured telephone peer-support for women experiencing postnatal depression. Pilot and exploratory RCT of its clinical and cost effectiveness

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McKenzie-McHarg Kirstie

2011-03-01

Full Text Available Abstract Background Postnatal depression (PND can be experienced by 13% of women who give birth, and such women often exhibit disabling symptoms, which can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later capacity for affect regulation. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. The Mums4Mums study aims to evaluate the impact of telephone peer-support for women experiencing PND. Methods/Design The study design adopts the MRC framework for the development and evaluation of complex interventions. Health visitors in Warwickshire and Coventry Primary Care Trusts are screening potential participants at the 8-week postnatal check using either the Edinburgh Postnatal Depression Scale (EPDS > = 10 or the three Whooley questions recommended by NICE (http://guidance.nice.org.uk/CG45. The Mums4Mums telephone support intervention is being delivered by trained peer-supporters over a period of four months. The primary outcome is depressive symptomatology as measured by the Edinburgh Postnatal Depression Scale. Secondary outcomes include mother-child interaction, dyadic adjustment, parenting sense of competence scale, and self-efficacy. Maternal perceptions of the telephone peer-support are being assessed using semi-structured interviews following the completion of the intervention. Discussion The proposed study will develop current innovative work in peer-led support interventions and telecare by applying existing expertise to a new domain (i.e. PND, testing the feasibility of a peer-led telephone intervention for mothers living with PND, and developing the relationship between the lay and clinical communities. The intervention will potentially benefit a significant number of patients and support a future application for a larger study to undertake a full evaluation of the clinical

Marked reduction in the number of platelet-tritiated imipramine binding sites in geriatric depression

International Nuclear Information System (INIS)

Nemeroff, C.B.; Knight, D.L.; Krishnan, R.R.; Slotkin, T.A.; Bissette, G.; Melville, M.L.; Blazer, D.G.

1988-01-01

The number (Bmax) and affinity (Kd) of platelet-tritiated imipramine binding sites was determined in young and middle-aged controls 50 years of age and younger (n = 25), elderly normal controls over 60 years of age (n = 18), patients who fulfilled DSM-III criteria for major depression who were under 50 years of age (n = 29), patients who fulfilled DSM-III criteria for major depression who were 60 years of age and older (n = 19), and patients who fulfilled both DSM-III criteria for primary degenerative dementia and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for probable Alzheimer's disease (n = 13). Both groups of depressed patients (under 50 and over 60 years of age) exhibited significant reductions (decreases 42%) in the number of platelet-tritiated imipramine binding sites with no change in affinity, when compared with their age-matched controls. There was little overlap in Bmax values between the elderly depressed patients and their controls. The patients with probable Alzheimer's disease showed no alteration in platelet-tritiated imipramine binding. There was no statistically significant relationship between postdexamethasone plasma cortisol concentrations and tritiated imipramine binding. These results indicate that platelet-tritiated imipramine binding may have potential utility as a diagnostic adjunct in geriatric depression, and moreover that the reduction in the number of platelet-tritiated imipramine binding sites is not due to hypercortisolemia

Semantic organizational strategy predicts verbal memory and remission rate of geriatric depression.

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Morimoto, Sarah Shizuko; Gunning, Faith M; Kanellopoulos, Dora; Murphy, Christopher F; Klimstra, Sibel A; Kelly, Robert E; Alexopoulos, George S

2012-05-01

This study tests the hypothesis that the use of semantic organizational strategy during the free-recall phase of a verbal memory task predicts remission of geriatric depression. Sixty-five older patients with major depression participated in a 12-week escitalopram treatment trial. Neuropsychological performance was assessed at baseline after a 2-week drug washout period. The Hopkins Verbal Learning Test-Revised was used to assess verbal learning and memory. Remission was defined as a Hamilton Depression Rating Scale score of ≤ 7 for 2 consecutive weeks and no longer meeting the DSM-IV-TR criteria for major depression. The association between the number of clusters used at the final learning trial (trial 3) and remission was examined using Cox's proportional hazards survival analysis. The relationship between the number of clusters utilized in the final learning trial and the number of words recalled after a 25-min delay was examined in a regression with age and education as covariates. Higher number of clusters utilized predicted remission rates (hazard ratio, 1.26 (95% confidence interval, 1.04-1.54); χ(2)  = 4.23, df = 3, p = 0.04). There was a positive relationship between the total number of clusters used by the end of the third learning trial and the total number of words recalled at the delayed recall trial (F(3,58) = 7.93; p < 0.001). Effective semantic strategy use at baseline on a verbal list learning task by older depressed patients was associated with higher rates of remission with antidepressant treatment. This result provides support for previous findings indicating that measures of executive functioning at baseline are useful in predicting antidepressant response. Copyright © 2011 John Wiley & Sons, Ltd.

Prevalence of Psychiatric Disorders among the Rural Geriatric Population: A Pilot Study in Karnataka, India

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Sreejith S. Nair

2015-03-01

Full Text Available Background: Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India.Methods: This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software.Results:We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196 as compared to males who had a prevalence of 42.4% (72 out of 170. The most common psychiatric disorder was depression (21.9%, and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of  affected individuals in 80+ age group.Conclusion: Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly.  A system that ensures comprehensive health care will have to be developed for

Prevalence of Psychiatric Disorders among the Rural Geriatric Population: A Pilot Study in Karnataka, India.

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Nair, Sreejith S; Raghunath, Pooja; Nair, Sreekanth S

2015-01-01

Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India. This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software. We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196) as compared to males who had a prevalence of 42.4% (72 out of 170). The most common psychiatric disorder was depression (21.9%), and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group. Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for this purpose as part of our future efforts.

Geriatric syndromes in patients with chronic kidney disease

OpenAIRE

Tomasz Gołębiowski; Hanna Augustyniak-Bartosik; Wacław Weyde; Marian Klinger

2016-01-01

The recent epidemiologic data pointed out, that the general number of patients on hemodialysis is steadily increasing, especially in group of elderly patients over 75 years old. The geriatric syndromes are a multietiological disorder related to physiological aging and partly associated with comorbid conditions. Frailty, falls, functional decline and disability, cognitive impairment and depression are main geriatric syndromes and occurs in patients with impaired renal function more often than ...

Evaluation of a geriatric assessment unit

NARCIS (Netherlands)

Gerritsen, J.C.; van der Ende, P.C.; Wolffensperger, Edwin; Boom, René

Psychogeriatric patients are a very vulnerable group among the elderly. A relative large proportion is institutionalized. In addition, many studies point to the heavy burden on the informal carers of psychogeriatric patients, frequently leading to depression. Geriatric expertise in primary care,

EVALUATION OF A GERIATRIC ASSESSMENT UNIT

NARCIS (Netherlands)

GERRITSEN, JC; VAN DER ENDE, PC; WOLFFENSPERGER, EW; BOOM, RC

Psychogeriatric patients are a very vulnerable group among the elderly. A relative large proportion is institutionalized. In addition, many studies point to the heavy burden on the informal carers of psychogeriatric patients, frequently leading to depression. Geriatric expertise in primary care,

Depression Stigma, Race, and Treatment Seeking Behavior and Attitudes

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Brown, Charlotte; Conner, Kyaien O.; Copeland, Valire Carr; Grote, Nancy; Beach, Scott; Battista, Deena; Reynolds, Charles F., III

2010-01-01

This study examined the relationship between internalized and public stigma on treatment-related attitudes and behaviors in a community sample of 449 African American and white adults aged 18 years and older. Telephone surveys were administered to assess level of depressive symptoms, demographic characteristics, stigma, and treatment-related…

Adherence to a Telephone-Supported Depression Self-Care Intervention for Adults With Chronic Physical Illnesses

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Russell Simco

2015-02-01

Full Text Available We assessed adherence to and predictors of two components of a telephone-supported self-care intervention for depression among primary care adults aged 40 and above with chronic physical illnesses and comorbid depressive symptoms. Participants received a “toolkit” containing six self-care tools. Trained lay self-care “coaches” negotiated a contact schedule of up to weekly contacts. Study outcomes were levels of completion of the self-care tool and the coach contacts at the 2-month follow-up. Coaches reported the number of completed contacts. In all, 57 of 63 participants completed the 2-month follow-up. Of these, 67% completed at least 1 tool; the mean number of coach contacts was 5.7 (SD = 2.4 of a possible 9 contacts (63% adherence. Higher disease comorbidity and lower initial depression severity independently predicted better tool adherence. Findings suggest that people with chronic physical illnesses can achieve acceptable levels of adherence to a depression self-care intervention similar to those reported for other populations.

Hierachy of needs of geriatric patients.

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Majercsik, E

2005-01-01

The aim of the study is to contribute to the improvement of the quality of care of geriatric patients. In order to be able to improve the geriatric care we have to know clearly the needs of the elderly patients. The hierarchy of needs of geriatric patients in clinical circumstances had to be assessed by a psychometric technique based on a motivational approach. The process was based on the method of paired comparisons, and a duly composed questionnaire was administered to the geriatric patients who were proven to have consistent thinking and surpassed a pre-established threshold in the Mini Mental State Examination. The evaluation of the responds leads to a numerical derivation (on an interval scale) of the hierarchy of needs. The received hierarchy of needs proved to oppose the general hypothesis of Maslow's motivation theory. This may induce a necessary shift in the approach to the care of the elderly, and accentuate the self-actualization and esteem needs beside the overtly emphasized physiological care. Copyright (c) 2005 S. Karger AG, Basel

Can Smartphones Enhance Telephone-Based Cognitive Assessment (TBCA)?

OpenAIRE

Rick Yiu-Cho Kwan; Claudia Kam-Yuk Lai

2013-01-01

TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then di...

Symptom profile of depression in elderly: Is assessment with geriatric depression rating scale enough?

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Aseem Mehra

2017-01-01

Full Text Available Aim of the Study: This study aimed to evaluate the symptom profile, including somatic symptoms among elderly patients with first episode depression using the Geriatric depression scale (GDS-30 and Patient Health Questionnaire-15 (PHQ-15 items version scale. Additional aims were to carry out the factor analysis of symptoms reported on GDS-30 and PHQ-15 among elderly. Methodology: Seventy-nine elderly patients (age ≥60 years were evaluated on GDS-30 item Hindi version and Hindi version of the PHQ-15. Results: As per GDS-30, the most common symptom noted among elderly was “dropped many of your activities and interests” (91.1%, mind not as clear as it used (88.6%, feeling that life is empty (86.1%, bothered by thoughts you cannot get out of your head (86.1% and hard to get started on new projects (86.1%, prefer to avoid social gatherings (86.1%. All patients reported at least one somatic complaint as per PHQ-15. The most common somatic symptoms were trouble sleeping (97.5%, feeling tired or having little energy (96.2%, feeling that the heart is racing (52.9%, constipation, loose bowels, or diarrhea (49.6%, shortness of breath (46.8%, nausea, gas or indigestion (45.6%, pain in the arms, legs, or joints (43.3%, and back pain (41.8%. The prevalence of somatic symptoms was not influenced to a large extent by the demographic variables, clinical variables and presence or absence of physical comorbidity. However, the severity of somatic symptoms correlated positively with GDS-30 score. Factor analysis of Hindi version of GDS-30 yielded a four-factor solution, which was similar to many studies across the world. The addition of items of PHQ-15 items of factor analysis still yielded a four-factor solution. Factor 1 of combined GDS-30 and PHQ-15 items included items only from GDS-30 and Factor 3 and 4 included items only from PHQ-15. There was some overlap of items on Factor 2. Conclusion: The present study suggests that GDS-30 does not tap all the

Geriatric syndromes in patients with chronic kidney disease

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Tomasz Gołębiowski

2016-06-01

Full Text Available The recent epidemiologic data pointed out, that the general number of patients on hemodialysis is steadily increasing, especially in group of elderly patients over 75 years old. The geriatric syndromes are a multietiological disorder related to physiological aging and partly associated with comorbid conditions. Frailty, falls, functional decline and disability, cognitive impairment and depression are main geriatric syndromes and occurs in patients with impaired renal function more often than among general population. The causes of higher prevalence of those syndromes are not well known, but uremic environment and overall renal replacement therapy may have an important impact on its progress. The patient with geriatric syndrome require comprehensive treatment as well as physical rehabilitation, psychiatric cure and support in everyday activities.Herein below we would like to review recent literature regarding to particular features of main geriatric syndromes in a group of nephrological patients.

The Effect of Music Therapy on Depression and Loneliness in Old People

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Fatemeh Sheibani Tazraji

2010-07-01

Full Text Available Objectives: The aim of this study was to investigate the effect of music therapy on depression and loneliness of elderly. Methods & Materials: Research instruments consisted of the Geriatric depression scale, Loneliness scale and music therapy package, all administered on 20 men and 18 women through a pretest-posttest with control group. Results: Results indicated that music therapy decreases depression in old people, ''friendship'' and ''affective loneliness'' in women but did not have meaningful effect on loneliness feeling of men. Conclusion: Results of this research suggested that listening to music can be used as solution for decreasing old people depression. The effect of this intervention was different among men and women. Their feelings of loneliness showed significant decline as well.

Development and inter-rater reliability of a standardized verbal instruction manual for the Chinese Geriatric Depression Scale-short form.

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Wong, M T P; Ho, T P; Ho, M Y; Yu, C S; Wong, Y H; Lee, S Y

2002-05-01

The Geriatric Depression Scale (GDS) is a common screening tool for elderly depression in Hong Kong. This study aimed at (1) developing a standardized manual for the verbal administration and scoring of the GDS-SF, and (2) comparing the inter-rater reliability between the standardized and non-standardized verbal administration of GDS-SF. Two studies were reported. In Study 1, the process of developing the manual was described. In Study 2, we compared the inter-rater reliabilities of GDS-SF scores using the standardized verbal instructions and the traditional non-standardized administration. Results of Study 2 indicated that the standardized procedure in verbal administration and scoring improved the inter-rater reliabilities of GDS-SF. Copyright 2002 John Wiley & Sons, Ltd.

[Geriatrics or geriatricization of medicine : Quo vadis geriatrics?

Science.gov (United States)

Kolb, G F

2017-12-01

This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence. This certainly includes the increasing acquisition of decentralized joint treatment concepts and geriatric counselling services in the future, in addition to the classical assessment instruments. Keywords in association with this are: traumatology and othopedics of the elderly, geriatric neurology and geriatric oncology. Interdisciplinary geriatric expertise is increasingly being requested. Outpatient structures have so far not been prioritized in geriatrics. An independent research is under construction and it is gratifying that academic interest in geriatrics seems to be increasing and new professorial chairs have been established. It is not possible to imagine our hospital without geriatrics; however, there is still a certain imbalance between the clearly increased number of geriatric hospital beds, the representation of geriatrics in large hospitals (e.g. specialized and maximum care hospitals and university clinics), the secure establishment in further education regulations and the lack of a uniform nationwide concept of geriatrics.

Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS: results of a randomized controlled trial.

Science.gov (United States)

Himelhoch, Seth; Medoff, Deborah; Maxfield, Jennifer; Dihmes, Sarah; Dixon, Lisa; Robinson, Charles; Potts, Wendy; Mohr, David C

2013-10-01

This pilot randomized controlled trial evaluated a previously developed manualized telephone based cognitive behavioral therapy (T-CBT) intervention compared to face-to-face (f2f) therapy among low-income, urban dwelling HIV infected depressed individuals. The primary outcome was the reduction of depressive symptoms as measured by the Hamliton rating scale for depression scale. The secondary outcome was adherence to HAART as measured by random telephone based pill counts. Outcome measures were collected by trained research assistants masked to treatment allocation. Analysis was based on intention-to-treat. Thirty-four participants met eligibility criteria and were randomly assigned to receive T-CBT (n = 16) or f2f (n = 18). There was no statistically significant difference in depression treatment outcomes comparing f2f to T-CBT. Within group evaluation demonstrated that both the T-CBT and the f2f psychotherapy groups resulted in significant reductions in depressive symptoms. Those who received the T-CBT were significantly more likely to maintain their adherence to antiretroviral medication compared to the f2f treatment. None of the participants discontinued treatment due to adverse events. T-CBT can be delivered to low-income, urban dwelling HIV infected depressed individuals resulting in significant reductions in depression symptoms and improved adherence to antiretroviral medication. Clinical Trial.gov identifier: NCT01055158.

Association between multiple geriatric syndromes and life satisfaction in community-dwelling older adults: A nationwide study in Taiwan.

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Yang, Deng-Chi; Lee, Jenq-Daw; Huang, Chi-Chang; Shih, Hsin-I; Chang, Chia-Ming

2015-01-01

Although previous studies have investigated the association between a single geriatric syndrome and life satisfaction in the older adults, the accumulated effects of multiple geriatric syndromes on life satisfaction remain unclear. We conducted a nationwide study by using data from the Taiwan Longitudinal Study on Aging database. A total of 2415 older adults were enrolled. Life satisfaction was evaluated according to the Life Satisfaction Index, and the geriatric syndromes included a depressive disorder, cognitive impairment, functional impairment, urine incontinence, pain, a fall, and polypharmacy. Other characteristics were age, sex, marital status, education level, self-rated health, and chronic diseases. Univariate analysis revealed that the older adults, who were illiterate, did not live with a partner, yet other issues such as stroke, malignancy, osteoarthritis, poor self-rated health, a depressive disorder, functional impairment, urine incontinence, or pain were associated with lower life satisfaction. In the multivariate regression model, the older adults who were male, illiterate, lived without a partner, had poor self-rated health, or had a depressive disorder were more likely to have lower life satisfaction. In addition, life satisfaction was unaffected in the older adults with only 1 geriatric syndrome, but among those with ≥2 geriatric syndromes, an increased number of geriatric syndromes were associated with lower life satisfaction. In addition to socio-demographic factors, cumulative effects of multiple geriatric syndromes might affect life satisfaction in the older adults. Further study of interventions for reducing geriatric syndromes to maintain life satisfaction is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Anxiety and depression in adults in their eighties: do gender differences remain?

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Pachana, Nancy A; McLaughlin, Deirdre; Leung, Janni; Byrne, Gerard; Dobson, Annette

2012-01-01

Women report higher rates of depression and anxiety than men; however, it is uncertain whether this gender difference continues into advanced old age. 78 men and 111 women aged 82-87 years from the Men, Women and Ageing Project completed measures of anxiety (Geriatric Anxiety Inventory), depression (Patient Health Questionnaire; PHQ9), general psychological well-being (Mental Health subscale of SF-36), general health (general health item of SF-36) and cognitive status (Telephone Interview for Cognitive Status; TICS). Results revealed no significant gender differences on any of the psychological measures, after controlling for cognitive status, general health and education. These results support the proposition that the female predominance in psychological distress diminishes with increasing age. The congruence between men and women may reflect changes in identity associated with age or the effect of decreased emotional valence of some social roles.

Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors.

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Rivera, Veronica; Yukawa, Michi; Aronson, Louise; Widera, Eric

2014-12-01

The entire healthcare workforce needs to be educated to better care for older adults. The purpose of this study was to determine whether fellows are being trained to teach, to assess the attitudes of fellowship directors toward training fellows to be teachers, and to understand how to facilitate this type of training for fellows. A nine-question survey adapted from a 2001 survey issued to residency program directors inquiring about residents-as-teachers curricula was developed and administered. The survey was issued electronically and sent out three times over a 6-week period. Of 144 ACGME-accredited geriatric fellowship directors from geriatric, internal medicine, and family medicine departments who were e-mailed the survey, 101 (70%) responded; 75% had an academic affiliation, 15% had a community affiliation, and 10% did not report. Academic and community programs required their fellows to teach, but just 55% of academic and 29% of community programs offered teaching skills instruction as part of their fellowship curriculum; 67% of academic programs and 79% of community programs felt that their fellows would benefit from more teaching skill instruction. Program directors listed fellow (39%) and faculty (46%) time constraints as obstacles to creation and implementation of a teaching curriculum. The majority of fellowship directors believe that it is important for geriatric fellows to become competent educators, but only approximately half of programs currently provide formal instruction in teaching skills. A reproducible, accessible curriculum on teaching to teach that includes a rigorous evaluation component should be created for geriatrics fellowship programs. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

[Association between depression and fall risk among elderly community residents].

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Tanaka, Mika; Kusaga, Mari; Ushijima, Kayo; Watanabe, Chiho

2012-01-01

To investigate the relationship between depression and fall risk in the elderly. Residents of a village in Kumamoto Prefecture, Japan (563 people), aged ≥65 years were given a self-administered questionnaire survey between June and July 2010. To evaluate depression status and fall risk, the Geriatric Depression Scale--Short Form and the Simple Screening Test for Risk of Falls were administered. Adjustment factors assessed were age, sex, medical history for diseases associated with falls, usage of hypnotics, and cognitive dysfunction. We examined the relationship between depression and fall risk using multiple logistic regression analysis. Given that some degree of correlation was expected among adjustment factors in the model, we constructed a model that introduced the adjustment factors stepwise to confirm the robustness of the model and any effect of multicollinearity. Overall (n=395), after excluding data from participants with significant cognitive disturbance or severe physical problems from among valid responders, a significant relationship was found between depression and fall risk in all models. The odds ratio was 2.28 (95% confidence interval: 1.31-3.96) in the final model, controlling for all adjustment factors. Our findings suggest a significant relationship between depression and fall risk in the elderly. This relationship implies that the improvement of depression could be an effective measure to decrease fall risk in the elderly.

Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30- and 60-Day Hospitalization: The Depression Care for Patients at Home Cluster-Randomized Trial.

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Bruce, Martha L; Lohman, Matthew C; Greenberg, Rebecca L; Bao, Yuhua; Raue, Patrick J

2016-11-01

To determine whether a depression care management intervention in Medicare home health recipients decreases risk of hospitalization. Cluster-randomized trial. Nurse teams were randomized to intervention (12 teams) or enhanced usual care (EUC; 9 teams). Six home health agencies from distinct geographic regions. Home health recipients were interviewed at home and over the telephone. Individuals aged 65 and older who screened positive for depression on nurse assessments (N = 755) and a subset who consented to interviews (n = 306). The Depression CARE for PATients at Home (CAREPATH) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted telephone conferences with team supervisors every 2 weeks. Hospitalization while receiving home health services was assessed using data from the home health record. Hospitalization within 30 days of starting home health, regardless of how long recipients received home health services, was assessed using data from the home care record and research assessments. The relative hazard of being admitted to the hospital directly from home health was 35% lower within 30 days of starting home health care (hazard ratio (HR) = 0.65, P = .01) and 28% lower within 60 days (HR = 0.72, P = .03) for CAREPATH participants than for participants receiving EUC. In participants referred to home health directly from the hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, P = .001) for CAREPATH participants. Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk in older adults receiving Medicare home health nursing services. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Long-term prognosis of geriatric major depression in relation to cognition and white matter integrity: follow up of two cases

Directory of Open Access Journals (Sweden)

Carlos Eduardo de Oliveira Alves

2012-01-01

Full Text Available INTRODUCTION: The geriatric depression (GD represents one of the most frequent psychiatric disorders in outpatient services specialized in old-age treatment. OBJECTIVE: The course of two illustrative cases of GD is discussed, highlighting its clinical picture after antidepressant treatment and underlining variables related to disease prognosis, treatment effectiveness and conversion to major cognitive disorders such as vascular dementia (VD. METHODS: The cognitive performance, depressive symptoms, autonomy and brain structural measurements as white matter hyperintensities (WMH and hippocampal size, and microstructural integrity of WM with diffusion tensor imaging were followed during four years. RESULTS: Case 1, with a severe degree of WMH, was associated with worsening cognition and increasing functional disability. Case 2, with mild WMH, an improvement of cognitive functioning could be seen. CONCLUSIONS: The existence of different subtypes of GD, as presented in this report, points a pathophysiological heterogeneity of GD, and suggests a possible continuum vascular depression (VaDp and vascular cognitive impairment (VCI.

HOspitals and patients WoRking in Unity (HOW R U?): protocol for a prospective feasibility study of telephone peer support to improve older patients' quality of life after emergency department discharge.

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Lowthian, Judy A; Lennox, Alyse; Curtis, Andrea; Dale, Jeremy; Browning, Colette; Smit, De Villiers; Wilson, Gillian; O'Brien, Debra; Rosewarne, Cate; Boyd, Lee; Garner, Cath; Cameron, Peter

2016-12-02

Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers. A multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in level of loneliness (UCLA-3 item Loneliness Scale), mood (Geriatric Depression Scale-5 item) and health-related quality of life (EQ-5D-5L and EQ-VAS) will also be measured postintervention (3 months). Research ethics and governance committee approval has been granted for this study by each participating centre (reference: 432/15 and 12-09-11-15). Study findings will inform the design and conduct of a future multicentre randomised controlled trial of a postdischarge volunteer-peer telephone support programme to improve social isolation, loneliness or depressive symptoms in older patients. Results will be disseminated through peer-reviewed journal publication, and conference and seminar presentation. ACTRN12615000715572, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effectiveness of a mood management component as an adjunct to a telephone counselling smoking cessation intervention for smokers with a past major depression: a pragmatic randomized controlled trial

NARCIS (Netherlands)

van der Meer, Regina M.; Willemsen, Marc C.; Smit, Filip; Cuijpers, Pim; Schippers, Gerard M.

2010-01-01

Aims To assess whether the addition of a mood management component to telephone counselling produces higher abstinence rates in smokers with past major depression and helps to prevent recurrence of depressive symptoms. Design Pragmatic randomized controlled trial with two conditions, with follow-up

Effectiveness of a mood management component as an adjunct to a telephone counselling smoking cessation intervention for smokers with a past major depression: A pragmatic randomized controlled trial

NARCIS (Netherlands)

van der Meer, R.; Willemsen, M.C.; Smit, H.F.E.; Cuijpers, P.; Schippers, G.M.

2010-01-01

Aims To assess whether the addition of a mood management component to telephone counselling produces higher abstinence rates in smokers with past major depression and helps to prevent recurrence of depressive symptoms. Design Pragmatic randomized controlled trial with two conditions, with follow-up

Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

Science.gov (United States)

Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

2017-01-01

Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

Effectiveness of telephone-based aftercare case management for adult patients with unipolar depression compared to usual care: A randomized controlled trial.

Directory of Open Access Journals (Sweden)

Laura Kivelitz

Full Text Available Patients with depression often have limited access to outpatient psychotherapy following inpatient treatment. The objective of the study was to evaluate the long-term effectiveness of a telephone-based aftercare case management (ACM intervention for patients with depression.We performed a prospective randomized controlled trial in four psychotherapeutic inpatient care units with N = 199 patients with major depression or dysthymia (F32.x, F33.x, F34.1, according to the ICD-10. The ACM consisted of six phone contacts at two-week intervals performed by trained and certified psychotherapists. The control group received usual care (UC. The primary outcome was depressive symptom severity (BDI-II at 9-month follow-up, and secondary outcomes were health-related quality of life (SF-8, EQ-5D, self-efficacy (SWE, and the proportion of patients initiating outpatient psychotherapy. Mixed model analyses were conducted to compare improvements between treatment groups.Regarding the primary outcome of symptom severity, the groups did not significantly differ after 3 months (p = .132; ES = -0.23 or at the 9-month follow-up (p = .284; ES = -0.20. No significant differences in health-related quality of life or self-efficacy were found between groups. Patients receiving ACM were more likely to be in outpatient psychotherapy after 3 months (OR: 3.00[1.12-8.07]; p = .029 and 9 months (OR: 4.78 [1.55-14.74]; p = .006 than those receiving UC.Although telephone-based ACM did not significantly improve symptom severity, it seems to be a valuable approach for overcoming treatment barriers to the clinical pathways of patients with depression regarding their access to outpatient psychotherapy.

Can smartphones enhance telephone-based cognitive assessment (TBCA)?

Science.gov (United States)

Kwan, Rick Yiu-Cho; Lai, Claudia Kam-Yuk

2013-12-12

TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then discuss the recent developments in tele-technology, the popularity of tele-technology among the elderly, potential benefits and challenges in using smartphones for cognitive assessment, and possible future developments in this technology. In the systematic review, eighteen TBCA instruments were identified. They were found to be valid in differentiating between people with and without dementia. TBCA was previously found to be launched on a conventional telephone platform. The advances in understanding of cognitive impairment may demand that telephones be equipped with more advanced features. Recently, the development and penetration of smartphones among the elderly has been rapid. This may allow the smartphone to enhance its TBCA applicability by overcoming the limitations of the conventional telephone, rendering the TBCA more efficient in addressing the increasing demand and complexity of cognitive assessments in the future. However, more research and technology developments are needed before smartphones can become a valid platform for TBCA.

Can Smartphones Enhance Telephone-Based Cognitive Assessment (TBCA?

Directory of Open Access Journals (Sweden)

Rick Yiu-Cho Kwan

2013-12-01

Full Text Available TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then discuss the recent developments in tele-technology, the popularity of tele-technology among the elderly, potential benefits and challenges in using smartphones for cognitive assessment, and possible future developments in this technology. In the systematic review, eighteen TBCA instruments were identified. They were found to be valid in differentiating between people with and without dementia. TBCA was previously found to be launched on a conventional telephone platform. The advances in understanding of cognitive impairment may demand that telephones be equipped with more advanced features. Recently, the development and penetration of smartphones among the elderly has been rapid. This may allow the smartphone to enhance its TBCA applicability by overcoming the limitations of the conventional telephone, rendering the TBCA more efficient in addressing the increasing demand and complexity of cognitive assessments in the future. However, more research and technology developments are needed before smartphones can become a valid platform for TBCA.

Geriatric trauma.

Science.gov (United States)

Adams, Sasha D; Holcomb, John B

2015-12-01

The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

Subcutaneously administered antibiotics: a national survey of current practice from the French Infectious Diseases (SPILF) and Geriatric Medicine (SFGG) society networks.

Science.gov (United States)

Forestier, E; Paccalin, M; Roubaud-Baudron, C; Fraisse, T; Gavazzi, G; Gaillat, J

2015-04-01

A national survey was performed to explore antibiotic prescription by the subcutaneous (sc) route among French infectious diseases and geriatric practitioners. Among the participating physicians, 367 (96.1%) declared administering sc antibiotics at some point. Ceftriaxone was prescribed sc by all but one, and ertapenem, teicoplanin, aminoglycosides and amoxicillin by 33.2%, 39.2%, 35.1% and 15.3%, respectively. The sc route was resorted to mainly in case of unavailable oral, intravenous or intramuscular routes, especially during palliative care. Pain, skin necrosis and lack of efficacy were the main adverse effects, reported by 70.8%, 12.8% and 19.9% of practitioners, respectively. Further studies are needed to precise the indications, modalities and tolerance of sc antibiotic use. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Depressive Symptoms and Risk of Postoperative Delirium.

Science.gov (United States)

Smith, Patrick J; Attix, Deborah K; Weldon, B Craig; Monk, Terri G

2016-03-01

Previous studies have shown that elevated depressive symptoms are associated with increased risk of postoperative delirium. However, to our knowledge no previous studies have examined whether different components of depression are differentially predictive of postoperative delirium. One thousand twenty patients were screened for postoperative delirium using the Confusion Assessment Method and through retrospective chart review. Patients underwent cognitive, psychosocial, and medical assessments preoperatively. Depression was assessed using the Geriatric Depression Scale-Short Form. Thirty-eight patients developed delirium (3.7%). Using a factor structure previously validated among geriatric medical patients, the authors examined three components of depression as predictors of postoperative delirium: negative affect, cognitive distress, and behavioral inactivity. In multivariate analyses controlling for age, education, comorbidities, and cognitive function, the authors found that greater behavioral inactivity was associated with increased risk of delirium (OR: 1.95 [1.11, 3.42]), whereas negative affect (OR: 0.65 [0.31, 1.36]) and cognitive distress (OR: 0.95 [0.63, 1.43]) were not. Different components of depression are differentially predictive of postoperative delirium among adults undergoing noncardiac surgery. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Pilot Randomized Controlled Trial of Titrated Subcutaneous Ketamine in Older Patients with Treatment-Resistant Depression.

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George, Duncan; Gálvez, Verònica; Martin, Donel; Kumar, Divya; Leyden, John; Hadzi-Pavlovic, Dusan; Harper, Simon; Brodaty, Henry; Glue, Paul; Taylor, Rohan; Mitchell, Philip B; Loo, Colleen K

2017-11-01

To assess the efficacy and safety of subcutaneous ketamine for geriatric treatment-resistant depression. Secondary aims were to examine if repeated treatments were safe and more effective in inducing or prolonging remission than a single treatment. In this double-blind, controlled, multiple-crossover study with a 6-month follow-up (randomized controlled trial [RCT] phase), 16 participants (≥60 years) with treatment-resistant depression who relapsed after remission or did not remit in the RCT were administered an open-label phase. Up to five subcutaneous doses of ketamine (0.1, 0.2, 0.3, 0.4, and 0.5 mg/kg) were administered in separate sessions (≥1 week apart), with one active control (midazolam) randomly inserted (RCT phase). Twelve ketamine treatments were given in the open-label phase. Mood, hemodynamic, and psychotomimetic outcomes were assessed by blinded raters. Remitters in each phase were followed for 6 months. Seven of 14 RCT-phase completers remitted with ketamine treatment. Five remitted at doses below 0.5 mg/kg. Doses ≥ 0.2 mg/kg were significantly more effective than midazolam. Ketamine was well tolerated. Repeated treatments resulted in higher likelihood of remission or longer time to relapse. Results provide preliminary evidence for the efficacy and safety of ketamine in treating elderly depressed. Dose titration is recommended for optimizing antidepressant and safety outcomes on an individual basis. Subcutaneous injection is a practical method for giving ketamine. Repeated treatments may improve remission rates (clinicaltrials.gov; NCT01441505). Copyright © 2017 American Association for Geriatric Psychiatry. All rights reserved.

Associations Between Geriatric Syndromes and Mortality in Community-Dwelling Elderly: Results of a National Longitudinal Study in Taiwan.

Science.gov (United States)

Huang, Chi-Chang; Lee, Jenq-Daw; Yang, Deng-Chi; Shih, Hsin-I; Sun, Chien-Yao; Chang, Chia-Ming

2017-03-01

Although geriatric syndromes have been studied extensively, their interactions with one another and their accumulated effects on life expectancy are less frequently discussed. This study examined whether geriatric syndromes and their cumulative effects are associated with risks of mortality in community-dwelling older adults. Data were collected from the Taiwan Longitudinal Study in Aging in 2003, and the participant survival status was followed until December 31, 2007. A total of 2744 participants aged ≥65 years were included in this retrospective cohort study; 634 died during follow-up. Demographic factors, comorbidities, health behaviors, and geriatric syndromes, including underweight, falls, functional impairment, depressive condition, and cognitive impairment, were assessed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the probability of survival according to the cumulative number of geriatric syndromes. The prevalence of geriatric syndromes increased with age. Mortality was significantly associated with age ≥75 years; male sex; ≤6 years of education; history of stroke, malignancy; smoking; not drinking alcohol; and not exercising regularly. Geriatric syndromes, such as underweight, functional disability, and depressive condition, contributed to the risk of mortality. The accumulative model of geriatric syndromes also predicted higher risks of mortality (N = 1, HR 1.50, 95% CI 1.19-1.89; N = 2, HR 1.69, 95% CI 1.25-2.29; N ≥ 3, HR 2.43, 95% CI 1.62-3.66). Community-dwelling older adults who were male, illiterate, receiving institutional care, underweight, experiencing a depressive condition, functionally impaired, and engaging in poor health behavior were more likely to have a higher risk of mortality. The identification of geriatric syndromes might help to improve comprehensive care for community-dwelling older adults. Copyright © 2016 AMDA – The Society for

Nursing Assessment and Intervention to Geriatric Patients Discharged From Emergency Department

DEFF Research Database (Denmark)

Rosted, Elizabeth Emilie; Poulsen, Ingrid; Hendriksen, Carsten

% of geriatric patients have complex and often unresolved caring needs. Objective: To examine the effect of a two-stage nursing assessment and intervention to address the patients uncompensated problems given just after discharge from ED and one and six months after. Method: We conducted a prospective...... nursing assessment comprising a checklist of 10 physical, mental, medical and social items. The focus was on unresolved problems which require medical intervention, new or different home care services, or comprehensive geriatric assessment. Following this the nurses made relevant referrals...... to the geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Findings: Primary endpoints will be presented as unplanned readmission to ED; admission to nursing home; and death. Secondary endpoints will be presented as physical function; depressive symptoms...

Influence of childhood abuse and neglect subtypes on late-life suicide risk beyond depression.

Science.gov (United States)

Behr Gomes Jardim, Gabriel; Novelo, Marta; Spanemberg, Lucas; von Gunten, Armin; Engroff, Paula; Nogueira, Eduardo Lopes; Cataldo Neto, Alfredo

2018-06-01

The association of childhood maltreatment and suicide has been extensively examined within the population. Depression figures as a main cause for the elevated suicide rate in advanced ages and is often related to childhood maltreatment. The purpose of the present study was to examine the relationship between childhood maltreatment subtypes and suicide risk, testing geriatric depression as a moderator. This is a cross-sectional study looking at a sample of 449 individuals 60 year s old or older from the Multidimensional Study of the Elderly of Porto Alegre Family Health Strategy, Brazil (EMI-SUS/POA). Childhood maltreatment (Childhood Trauma Questionnaire), geriatric depressive symptoms (Geriatric Depression Scale), and suicide risk (Mini International Neuropsychiatric Interview) were assessed. The subtypes of childhood abuse and neglect were significantly associated with suicide risk. In the multivariate analysis, controlling for age, gender, income, marital status, ethnicity, smoking, and geriatric depression symptoms, all trauma subtypes remained associated with suicide risk with the exception of physical neglect (EA = 3.65; PA = 3.16; SA = 5.1; EN = 2.43; PN = 1.76). The present study showed that childhood maltreatment subtypes predicted suicide risk, and geriatric depression does not directly mediate this relation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Depression screening among older adults attending low-vision rehabilitation and eye-care services: Characteristics of those who screen positive and client acceptability of screening.

Science.gov (United States)

Holloway, Edith E; Sturrock, Bonnie A; Lamoureux, Ecosse L; Keeffe, Jill E; Rees, Gwyneth

2015-12-01

To investigate characteristics associated with screening positive for depressive symptoms among older adults accessing low-vision rehabilitation and eye-care services and to determine client acceptability of depression screening using the Patient Health Questionnaire-2 (PHQ-2) in these settings. One-hundred and twenty-four older adults (mean = 77.02 years, SD = 9.12) attending low-vision rehabilitation and eye-care services across Australia were screened for depression and invited to complete a telephone-administered questionnaire to determine characteristics associated with depressive symptoms and client acceptability of screening in these settings. Thirty-seven per cent (n = 46/124) of participants screened positive for depressive symptoms, and the majority considered the new depression screening method to be a 'good idea' in vision services (85%). Severe vision loss (<6/60 in the better eye) was associated with an increased odds of screening positive for depressive symptoms (odds ratio 2.37; 95% confidence interval 1.08-6.70) even after adjusting for potential confounders. Participants who screened positive had a preference for 'talking' therapy or a combination of medication and 'talking therapy' delivered within their own home (73%) or via telephone (67%). The PHQ-2 appears to be an acceptable method for depression screening in eye-care settings among older adults. Targeted interventions that incorporate home-based or telephone delivered therapy sessions may improve outcomes for depression in this group. © 2014 ACOTA.

Comparison of escitalopram versus citalopram for the treatment of major depressive disorder in a geriatric population.

Science.gov (United States)

Wu, Eric; Greenberg, Paul E; Yang, Elaine; Yu, Andrew; Erder, M Haim

2008-09-01

To compare escitalopram versus citalopram for the treatment of major depressive disorder (MDD) in geriatric patients. Administrative claims data (2003-2005) were analyzed for patients aged > or =65 years with at least one inpatient claim or two independent medical claims associated with MDD diagnosis. Patients were continuously enrolled for at least 12 months, filled at least one prescription for citalopram or escitalopram and had no second generation antidepressant use during the 6-month pre-index date. Contingency table analysis and survival analysis were used to compare outcomes between the two treatment groups. Treatment persistence, hospitalization utilization, and prescription drug, medical, and total healthcare costs were analyzed. Outcomes were compared between patients initiated on escitalopram and those initiated on citalopram both descriptively and using multivariate analysis adjusting for baseline characteristics. Among 691 geriatric patients, escitalopram-treated patients (n=459) were less likely to discontinue treatment (hazard ratio [HR]=0.83, p=0.049) or switch to another second generation antidepressant (HR=0.62, p=0.001) compared to patients treated with citalopram (n=232). Patients treated with escitalopram had a significantly lower hospitalization rate (31.2% vs. 38.8%, p=0.045) and 66% fewer hospitalization days based on negative binomial regression (pescitalopram patients had comparable prescription drug costs, they had lower total medical service costs (regression: $9748 vs. $19,208, pescitalopram had better treatment persistence, fewer hospitalizations, and lower medical and total healthcare costs than patients treated with citalopram. Most of the cost reduction was attributable to significantly lower hospitalizations and total medical costs.

Rapid psychological assessment of depression and its relationship with physical health among urban elderly

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Pavithra Cheluvaraj

2016-07-01

Full Text Available Background Old age is associated with increased occurrence of a wide array of Psychological impairments or losses, which might contribute to physical disabilities. As Depression has been identified as the most common aberration its rapid assessment would be able to identify the quality of individual and family life of the elderly. Aims To assess psychological health status with respect to depression among geriatric urban community, and the relationship of depression with health perception and physical health status has been explored. Methods A cross-sectional total geriatric population survey consisting of 254 elderly has been carried out at urban field practice area. A standard geriatric depression scale (Short form has been utilized to assess psychological status. Detailed physical examination and investigations with special reference to Diabetes, Hypertension and Visual defects was carried out. Data was analyzed to find out the relationship of various socio-demographic factors, physical morbidities with depression. Results Out of 254 elderly examined, 32 per cent females and 23 per cent males were found to be suffering from depressive disorders. When assessed for individual health status perception, 25 per cent felt to have good health. Out of 190 geriatric subjects perceiving fair to bad health, 110 were found to be suffering from depression (p<0.001. Depression was also found to be associated with history of hospital admission in the previous year (p<0.05, low vision (p<0.05, diabetes (p<0.01 and hypertension (p<0.01. Conclusion Depression among geriatric age group is associated with physical illness and perception of health.

A randomized clinical trial of a telephone depression intervention to reduce employee presenteeism and absenteeism.

Science.gov (United States)

Lerner, Debra; Adler, David A; Rogers, William H; Chang, Hong; Greenhill, Annabel; Cymerman, Elina; Azocar, Francisca

2015-06-01

The study tested an intervention aimed at improving work functioning among middle-aged and older adults with depression and work limitations. A randomized clinical trial allocated an initial sample of 431 eligible employed adults (age ≥45) to a work-focused intervention (WFI) or usual care. Inclusion criteria were depression as measured by the Patient Health Questionnaire-9 (PHQ-9) and at-work limitations indicated by a productivity loss score ≥5% on the Work Limitations Questionnaire (WLQ). Study sites included 19 employers and five related organizations. Telephone-based counseling provided three integrated modalities: care coordination, cognitive-behavioral therapy strategy development, and work coaching and modification. Effectiveness (change in productivity loss scores from preintervention to four months postintervention) was tested with mixed models adjusted for confounders. Secondary outcomes included change in WLQ work performance scales, self-reported absences, and depression. Of 1,227 eligible employees (7% of screened), 431 (35%) enrolled and 380 completed the study (12% attrition). At-work productivity loss improved 44% in the WFI group versus 13% in usual care (difference in change, p<.001). WFI group scores on the four WLQ scales improved 44% to 47%, significantly better than in usual care (p<.001 for each scale). Absence days declined by 53% in the WFI group versus 13% in usual care (difference in change, p<.001). Mean PHQ-9 depression symptom severity scores declined 51% for WFI versus 26% for usual care (difference in change, p<.001). The WFI was more effective than usual care at four-month follow-up. Given increasing efforts to provide more patient-centered, value-based care, the WFI could be an important resource.

[Screening of the risk of functional decline performed by an inpatient geriatric consultation team in a general hospital].

Science.gov (United States)

Benoît, F; Bertiaux, M; Schouterden, R; Huard, E; Segers, K; Decorte, L; Robberecht, J; Simonetti, C; Surquin, M

2013-01-01

The Mobile Geriatric Team (MGT) is part of the Geriatric Care Program and aims to provide interdisciplinary geriatric expertise to other professionals for old patients hospitalized outside geriatric department. Our hospital has a MGT since 2008. Our objective is to retrospectively describe the population of patients of 75 years and older hospitalized outside the geriatric ward and screened for the risk of functional decline by the MGT between 1 October 2009 and 30 September 2011. We recorded the risk of functional decline, as indicated by the Identification of Senior At Risk score (ISAR) performed within 48 h after admission, place of living, discharge destination, Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS) scores. In two years, 1.568 patients > or = 75 Y were screened with the ISAR score (mean age 82.5 Y, 60.7% of women). We identified 833 patients with a high-risk of functional decline (ISAR > or = 3). The majority of high-risk subjects (78%) were living at home before hospitalization and 58.7% returned home after discharge. Depression and cognitive impairment were identified among respectively 41% and 59% of high-risk subjects. Only 128 patients were admitted for fall. Most of the faller patients were living at home prior hospitalization and had an ISAR score > or = 3. The MGT allowed identifying many patients > or = 75 Y living at home and presenting with high-risk of functional decline and geriatric syndromes, confirming that good screening procedures are necessary to optimize management of hospitalized olders. Most of faller patients have an ISAR score > or = 3 and should benefit a comprehensive geriatric assessment.

Fatigue in a cohort of geriatric patients with and without Parkinson's disease

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F.O. Goulart

2009-08-01

Full Text Available We evaluated the frequency of fatigue in geriatric patients with and without Parkinson's disease (PD and correlated it with depression and excessive daytime sleepiness. We evaluated 100 patients from Hospital São Paulo, 50 with PD from the Neurologic Outpatient Clinic and 50 with non-neurologic diseases or oncologic diseases from the Geriatric Outpatient Clinic (controls. All patients who scored 28 or more on the Fatigue Severity Scale (FSS were considered to have fatigue. Also, all patients were submitted to a structured interview to diagnose depression by the criteria of the American Psychiatric Association (DSM-IV, 4th version and were evaluated by the Modified Impact of Fatigue Scale and the Epworth Sleepiness Scale (ESE to detect excessive daytime sleepiness. Demographic and disease details of all PD patients were recorded and the patients were examined and rated by the Unified Parkinson's Disease Rating Sale (UPDRS and Hoehn-Yahr staging. Frequency of fatigue (FSS ≥28 was 70% for PD and 22% for controls. Twenty of 35 PD patients with fatigue had concomitant depression. Compared to controls, PD patients were found more frequently to have depression by DSM-IV criteria (44 vs 8%, respectively and excessive daytime sleepiness by the ESE (44 vs 16%, although only depression was associated with fatigue. Fatigue was more frequent among depressed PD and control patients and was not correlated with PD duration or with UPDRS motor scores. ESE scores did not differ between patients with or without fatigue.

Garden walking for depression: a research report.

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McCaffrey, Ruth; Hanson, Claire; McCaffrey, William

2010-01-01

This study was designed to determine the effect of garden walking and reflective journaling on adults who are 65 years old and older with depression. The Geriatric Depression Scale measured depression. Four themes emerged from the interview data collected from each participant.

Screening for depression and assessing change in severity of depression. Is the Geriatric Depression Scale (30-.15- and 8- item versions) useful for both purposes in nursing home patients?

NARCIS (Netherlands)

Smalbrugge, M.; Jongenelis, L.; Pot, A.M.; Eefsting, J.A.; Beekman, A.T.F.

2008-01-01

The objectives of this study were to determine the ability of the 30-, 15- and 8-item versions of the GDS for screening and assessing change in severity of depression in nursing home patients. The GDS and the MADRS were administered to 350 elderly NH-patients by trained interviewers. The presence of

Practice of geriatric oncology in the setting of a comprehensive cancer center

International Nuclear Information System (INIS)

Droz, J.

2004-01-01

subjectively appreciate performance status. Folstein’s Mini Mental State Examination (MMSE) was used to evaluate patient cognitive status. Depressive symptoms were detected with the Geriatric Depression Scale (GDS). Nutritional status was assessed through the Mini-Nutritional Assessment (MNA). The Performance-Oriented Assessment of Mobility instrument provided information on patient physical ability and fall risk. Co morbidity, that corresponds to all medical conditions a patient may have, excluding the disease of primary interest, was assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G). This scale classifies co morbid events by organ system affected, and rates their severity from 0 to 4, with a grading similar to that of the Common Toxicity Criteria scale (none, mild, moderate, severe, extremely severe/life-threatening). This scale has 14 organ system categories and collects information such as the total number of categories involved, total score, severity index (total score/total number of categories involved), the number of categories at level 3 severity, the number of categories at level 4 severity. We also assessed biological functions such as hemoglobin, white blood cell count and differential, creatinine clearance, serum albumin level. Mini-CGA is performed by a multidisciplinary team, including a geriatric ian, a medical oncologist (geriatrics certified), a social worker, a dietician, a physiotherapist, a pharmacist and a research nurse. Each mini-CGA evaluation lasts from ninety to one hundred and twenty minutes. At the end of the procedure, both the geriatric ian and the oncologist draw up an inventory of the different problems identified, and propose an individualized intervention program with specific advice on cancer treatment options

Assessment of depression in a geriatric inpatient cohort: A comparison of the BDI and GDS

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Bret G. Bentz

2008-01-01

Full Text Available El propósito de esta investigación fue comparar la habilidad para evaluar y clasificar la depresión del Beck Depression Inventory (BDI y de la Geriatric Depression Scale (GDS en pacientes geriátricos. Se realizó una revisión retrospectiva de los registros médicos de 158 pacientes consecutivamente admitidos en una unidad geriátrica. Los datos recabados incluyeron diagnósticos, información demográfica, puntuaciones del BDI y del GDS, y puntuaciones de varios tests neuropsicológicos. Los ítems de ambos cuestionarios fueron sometidos a análisis factorial para obtener constructos ortogonales. Además, los ítems de ambos cuestionarios fueron tratados mediante análisis discriminante con objeto de investigar su habilidad para diagnosticar la depresión. Finalmente, las puntuaciones de cada factor y las totales de cada cuestionario fueron correlacionadas con medidas de funcionamiento neuropsicológico. Los resultados indicaron que tanto el BDI como el GDS tienen estructuras multifactoriales y su utilidad para diagnosticar la depresión es cuestionable. Además, se obtuvo que el factor de Síntomas Vegetativos del BDI correlacionaba significativamente con varias medidas de funcionamiento neuropsicológico. Los resultados se discutieron en términos de la utilidad clínica relativa de estas dos medidas de auto-informe para la depresión.

Association between falls and depressive symptoms or visual impairment among Japanese young-old adults.

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Kojima, Reiji; Ukawa, Shigekazu; Ando, Masahiko; Kawamura, Takashi; Wakai, Kenji; Tsushita, Kazuyo; Tamakoshi, Akiko

2016-03-01

To investigate the association between falls and self-reported depressive symptoms or visual impairment among young-old adults. A total of 1904 participants (986 men and 918 women) aged 64 years from the New Integrated Suburban Seniority Investigation Project from 1996 to 2005, an age-specific cohort study in Nisshin, Japan, took part in the present study. Depressive symptoms were evaluated using the Geriatric Depression Scale. Visual impairment was assessed using a self-administered questionnaire. The outcome variable was self-reported injurious falls at the age of 70 years. Multivariate odds ratios (OR) and 95% confidence intervals (CI) of depressive symptoms and visual impairment for the incidence of falls were calculated using logistic regression models and adjusted for possible confounding factors. Overall, 77 (7.8%) men and 126 (13.7%) women reported falls within the past 1 year at age 70 years. Among women, depressive symptoms and visual impairment were significantly associated with falls after adjusting for potential confounders (OR 1.70, 95% CI 1.09-2.62; OR 2.34, 95% CI 1.45-3.71, respectively), but not among men. Women with both conditions had a significantly increased risk of falls after adjusting for potential confounders (OR 3.50, 95% CI 1.65-7.13) compared with those with neither condition; the association was not significant among men. Depressive symptoms and visual impairment at age 64 years were significantly associated with an increased risk of falls at age 70 years in Japanese women but not in men. The combination of the two symptoms had an even greater association with fall risk. © 2015 Japan Geriatrics Society.

Long-term deficiency of circulating and hippocampal insulin-like growth factor I induces depressive behavior in adult mice: A potential model of geriatric depression

Science.gov (United States)

Mitschelen, Matthew; Yan, Han; Farley, Julie A.; Warrington, Junie P.; Han, Song; Hereñú, Claudia B.; Csiszar, Anna; Ungvari, Zoltan; Bailey-Downs, Lora C.; Bass, Caroline E.; Sonntag, William E.

2011-01-01

Numerous studies support the hypothesis that deficiency of insulin-like growth factor I (IGF-1) in adults contributes to depression, but direct evidence is limited. Many psychological and pro-cognitive effects have been attributed to IGF-1, but appropriate animal models of adult-onset IGF-1 deficiency are lacking. In this study, we use a viral-mediated Cre-loxP system to knockout the Igf1 gene in either the liver, neurons of the CA1 region of the hippocampus, or both. Knockout of liver Igf1 reduced serum IGF-1 levels by 40% and hippocampal IGF-1 levels by 26%. Knockout of Igf1 in CA1 reduced hippocampal IGF-1 levels by 13%. The most severe reduction in hippocampal IGF-1 occurred in the group with knockouts in both liver and CA1 (36% reduction), and was associated with a 3.5-fold increase in immobility in the forced swim test. Reduction of either circulating or hippocampal IGF-1 levels did not alter anxiety measured in an open field and elevated plus maze, nor locomotion in the open field. Furthermore, local compensation for deficiencies in circulating IGF-1 did not occur in the hippocampus, nor were serum levels of IGF-1 upregulated in response to the moderate decline of hippocampal IGF-1 caused by the knockouts in CA1. We conclude that adult-onset IGF-1 deficiency alone is sufficient to induce a depressive phenotype in mice. Furthermore, our results suggest that individuals with low brain levels of IGF-1 are at increased risk for depression and these behavioral effects are not ameliorated by increased local IGF-1 production or transport. Our study supports the hypothesis that the natural IGF-1 decline in aging humans may contribute to geriatric depression. PMID:21524689

Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.

Science.gov (United States)

Southerland, Lauren T; Gure, Tanya R; Ruter, Daniel I; Li, Michael M; Evans, David C

2017-08-01

The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation. Secondary analyses evaluated adherence by service: trauma service (Trauma) or a trauma service with early geriatric consultation (GeriTrauma). The average age of the 245 patients was 76.7 years, 47% were women, and mean Injury Severity Score was 9.5 (SD ±8.1). Implementation of the GeriTrauma collaborative increased geriatric consultation rates from 2% to 48% but had minimal effect on overall adherence to TQIP quality measures. A secondary analysis comparing those in the post implementation group who received geriatric consultation (n = 94) to those who did not (n = 103) demonstrated higher rates of delirium diagnosis (36.2% vs 14.6%, P quality indicators is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Geriatric syndromes: medical misnomer or progress in geriatrics?

NARCIS (Netherlands)

Olde Rikkert, M.G.M.; Rigaud, A.S.; Hoeyweghen, R.J. van; Graaf, J. de

2003-01-01

Both in geriatric and internal medicine journals, and in medical textbooks certain (aggregates of) symptoms are labelled as 'geriatric syndromes'. In frail elderly patients a large number of diseases present with well-known and highly prevalent atypical symptoms (e.g. immobility, instability,

Telephone versus face-to-face interviewing for household drug use surveys.

Science.gov (United States)

Aquilino, W S

1992-01-01

This research investigated the use of telephone versus face-to-face interviewing to gather data on the use of tobacco, alcohol, and illicit drugs. Telephone and personal drug use surveys of the 18-34 year-old household population were conducted in the state of New Jersey in 1986-1987. Survey modes were compared in terms of unit and item nonresponse rates, sample coverage, and levels of self-reported drug use. Results showed that the telephone survey achieved response rates lower than the personal survey, but comparable to telephone surveys of less threatening topics. Item nonresponse to sensitive drug questions was lower by phone than with the self-administered answer sheets in the personal mode. The exclusion of households without telephones in the telephone survey is a potential source of bias, and may lead to underestimation of alcohol and drug use for minority populations. After controlling for telephone status, the telephone survey furnished significantly lower drug use estimates on several indicators than the personal survey, with the largest mode differences found for Blacks.

Geriatric Fever Score: a new decision rule for geriatric care.

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Min-Hsien Chung

Full Text Available Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups.Consecutive geriatric patients (≥65 years old visiting the emergency department (ED of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done.Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3, Severe coma (GCS ≤ 8, and Thrombocytopenia (platelets <150 10(3/mm3 (LST. After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0% (95% CI: 2.3-6.9%: a general ward or treatment in the ED then discharge and high (30.3% (95% CI: 17.4-47.3%: consider the intensive care unit. The area under the curve for the rule was 0.73.We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

Clinical correlates of resilience factors in geriatric depression.

Science.gov (United States)

Laird, Kelsey T; Lavretsky, Helen; Paholpak, Pattharee; Vlasova, Roza M; Roman, Michael; St Cyr, Natalie; Siddarth, Prabha

2018-01-16

Traditional perspectives conceptualize resilience as a trait and depression as resulting from resilience deficiency. However, research indicates that resilience varies substantially even among adults who are clinically depressed, as well as across the lifespan of an individual. Few studies have investigated resilience in depression, and even fewer have examined resilience in depressed older adults. Three hundred thirty-seven adults ≥60 years with major depressive disorder completed the Connor-Davidson Resilience Scale (CD-RISC) and measures of mental health, quality of life (QOL), and medical comorbidity. Exploratory factor analysis was used to explore the factor structure of the CD-RISC. Correlations and general linear models were used to examine associations between resilience and other variables. The rotated component matrix indicated a four-factor model. Sorting of items by highest factor loading revealed constructs associated with (1) grit, (2) active coping self-efficacy, (3) accommodative coping self-efficacy, and (4) spirituality. Resilience was significantly correlated with increased age, lower cognitive functioning, greater cerebrovascular risk, and greater medical comorbidity. Resilience was negatively associated with mental health symptoms (depression, apathy, and anxiety) and positively associated with QOL. The final optimal model identified less depression, less apathy, greater medical comorbidity, higher QOL, and minority (non-White) race as factors that significantly explained variability in resilience. Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.

The association between nutritional status and frailty characteristics among geriatric outpatients.

Science.gov (United States)

Kurkcu, M; Meijer, R I; Lonterman, S; Muller, M; de van der Schueren, M A E

2018-02-01

Frailty is a common clinical syndrome in older adults and is associated with an increased risk of poor health outcomes, e.g. falls, disability, hospitalization, and mortality. Nutritional status might be an important factor contributing to frailty. This study aims to describe the association between nutritional status and characteristics of frailty in patients attending a geriatric outpatient clinic. Clinical data was collected of 475 patients who visited the geriatric outpatient department of a Dutch hospital between 2005 and 2010. Frailty was determined by: incontinence, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), mobility, Geriatric Depression Scale (GDS) and Mini Mental State Exam (MMSE). Nutritional status was represented by the Mini Nutritional Assessment (MNA) and plasma concentrations of several micronutrients, whereby MNAnutritional status could prove usefulness in early clinical detection and prevention of frailty. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Telephone Care Management of Fall Risk:: A Feasibility Study.

Science.gov (United States)

Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

2017-03-01

Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Feed-back between geriatric syndromes: general system theory in geriatrics.

Science.gov (United States)

Musso, Carlos G; Núñez, Juan F Macías

2006-01-01

Geriatrics has described three entities: confusional syndrome, incontinente and gait disorders, calling them geriatric giants. Aging process also induces changes in renal physiology such as glomerular filtration rate reduction, and alteration in water and electrolytes handling. These ageing renal changes have been named as nephrogeriatric giants. These two groups of giants, geriatric and nephrogeriatric, can predispose and potentiate each other leading old people to fatal outcomes. These phenomenon of feed-back between these geriatric syndromes has its roots in the loss of complexity that the ageing process has. Complexity means that all the body systems work harmoniously. The process of senescence weakens this coordination among systems undermining complexity and making the old person frail.

Falls and depression in older people.

Science.gov (United States)

Turcu, Alin; Toubin, Sandrine; Mourey, France; D'Athis, Philippe; Manckoundia, Patrick; Pfitzenmeyer, Pierre

2004-01-01

Depression is one of the most common risk factors for falls, but links between falls and depression are still unclear. Few studies have examined the relationship between depression and gait alteration, which may increase the risk of fall. This study aims to assess a possible relationship between depression, postural and gait abnormalities, and falls. We conducted a 1-year prospective study on patients >/=70 years who were admitted to a geriatric unit for 'spontaneous' unexplained falls. Patients were tested for depression using the 30-item Geriatric Depression Scale (GDS). Their motor performances were assessed using the Mini Motor Test (MMT), which is an easy direct-observation test, validated in France, for assessment of frail old people who present with severe postural and gait impairment. This scale is composed of 4 categories of items: (1) abilities in bed; (2) quality of the sitting position; (3) abilities in the standing position, and (4) quality of gait. Sixty-nine patients were included. Depression was found in 46 patients (66.7%). The MMT score was higher in the non-depressed fallers (NDF) group (GDS 10; p predispose to falls. In clinical practice, more attention should be given to old fallers concerning diagnosis and treatment of associated depression. Copyright 2004 S. Karger AG, Basel

Antidepressant treatment of depression in rural nursing home residents.

Science.gov (United States)

Kerber, Cindy Sullivan; Dyck, Mary J; Culp, Kennith R; Buckwalter, Kathleen

2008-09-01

Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by their primary care provider than women. Depression detected by nurses through the Minimum Data Set was treated at a lower rate with antidepressants, which generates issues related to interprofessional communication, nursing staff communication, and the need for geropsychiatric role models in nursing homes.

Symptom Dimensions of Depression and 3-Year Incidence of Dementia : Results From the Amsterdam Study of the Elderly

NARCIS (Netherlands)

Lugtenburg, Astrid; Zuidersma, Marij; Oude Voshaar, Richard C; Schoevers, Robert A

OBJECTIVE: To evaluate the association between depressive symptom dimensions and incident dementia in a community sample of older persons. METHODS: Depressive symptoms at baseline and incident dementia at 3-year follow-up were assessed with the Geriatric Mental State (GMS)-Automated Geriatric

[Psychometric validation of the telephone memory test].

Science.gov (United States)

Ortiz, T; Fernández, A; Martínez-Castillo, E; Maestú, F; Martínez-Arias, R; López-Ibor, J J

1999-01-01

Several pathologies (i.e. Alzheimer's disease) that courses with memory alterations, appears in a context of impaired cognitive status and mobility. In recent years, several investigations were carried out in order to design short batteries that detect those subjects under risk of dementia. Some of this batteries were also design to be administrated over the telephone, trying to overcome the accessibility limitations of this patients. In this paper we present a battery (called Autotest de Memoria) essentially composed by episodic and semantic memory tests, administered both over the telephone and face to face. This battery was employed in the cognitive assessment of healthy controls and subjects diagnosed as probable Alzheimer's disease patients. Results show the capability of this battery in order to discriminate patients and healthy controls, a great sensibility and specificity, and a nearly absolute parallelism of telephone and face to face administrations. These data led us to claim the usefulness and practicality of our so called Memoria>.

Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer.

Science.gov (United States)

Yamamoto, Masaaki; Yamasaki, Makoto; Sugimoto, Ken; Maekawa, Yoshihiro; Miyazaki, Yasuhiro; Makino, Tomoki; Takahashi, Tsuyoshi; Kurokawa, Yukinori; Nakajima, Kiyokazu; Takiguchi, Shuji; Rakugi, Hiromi; Mori, Masaki; Doki, Yuichiro

2016-11-01

The number of geriatric patients with esophageal cancer is increasing in step with the aging of the population. Geriatric patients have a higher risk of postoperative complications, including delirium that can cause a fall or impact survival. Therefore, it is very important that we evaluate risks of postoperative complications before surgery. The aim of this study was to predict postoperative delirium in elderly patients. We retrospectively reviewed the medical records of 91 patients aged 75 years and over who underwent esophagectomy between January 2006 and December 2014. We investigated the association between postoperative delirium and clinicopathological factors, including comprehensive geriatric assessment (CGA). Postoperative delirium developed in 24 (26 %) patients. Postoperative delirium was significantly associated with low mini-mental state examination (MMSE) and high Geriatric Depression Scale 15 (GDS15), which are components of CGA, and psychiatric disorder (P patients undergoing esophagectomy for esophageal cancer. Intervention by a multidisciplinary team using CGA might help prevent postoperative delirium.

Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

DEFF Research Database (Denmark)

Sletvold, O; Tilvis, R; Jonsson, A

1996-01-01

A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help f...... languages, and the translated versions should ideally have been subjected to validity and reliability testing. However, so far no scale meets these demands regarding all the five Nordic languages.......A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help...... for the clinician concerned with hospital based geriatric medicine. It may also be useful for quality control and teaching. Not least, it may be useful for health professionals other than geriatricians. To some extent, the position of geriatric medicine in the Nordic countries varies between the countries. However...

The role of geriatric assessment tests and anthropometric measurements in identifying the risk of falls in elderly nursing home residents

Science.gov (United States)

Yardimci, Bulent; Aran, Sinan N.; Ozkaya, Ismail; Aksoy, Sevki M.; Demir, Tarik; Tezcan, Gulsen; Kaptanoglu, Aysegul Y.

2016-01-01

Objectives: To determine the relation among the risk of falls, geriatric assessment, and anthropometric measurements, including the mini mental state examination, geriatric depression scale, handgrip test, and key pinch test. Methods: This prospective study included 89 residents hospitalized between May 2014 and September 2015 in the geriatric care unit of the Istanbul Balikli Rum Hospital, Istanbul, Turkey. Patients were followed-up for one year, and their falls were recorded. Medical records of the included patients were retrieved and analyzed. Results: A total of 89 patients, comprising 37 men and 52 women with an average age of 75.8 ± 8.2 years were included in the study. The residents’ annual falling averages were 1.0 ± 1.5. The most significant factors were identified to be predicted muscle mass, skeletal muscle index, whole body bioimpedance, dominant arm muscle strength, dominant arm bioimpedance, and free fat mass. Conclusions: The mini mental test, geriatric depression scale and lawton-brody scale combined with the handgrip, 6-meters walking, and bioimpedance tests are favorable for detecting the risk of falls and recurrent falls in vulnerable elderly nursing home residents. PMID:27652361

Cellular telephones measure activity and lifespace in community-dwelling adults: proof of principle.

Science.gov (United States)

Schenk, Ana Katrin; Witbrodt, Bradley C; Hoarty, Carrie A; Carlson, Richard H; Goulding, Evan H; Potter, Jane F; Bonasera, Stephen J

2011-02-01

To describe a system that uses off-the-shelf sensor and telecommunication technologies to continuously measure individual lifespace and activity levels in a novel way. Proof of concept involving three field trials of 30, 30, and 21 days. Omaha, Nebraska, metropolitan and surrounding rural region. Three participants (48-year-old man, 33-year-old woman, and 27-year-old male), none with any functional limitations. Cellular telephones were used to detect in-home position and in-community location and to measure physical activity. Within the home, cellular telephones and Bluetooth transmitters (beacons) were used to locate participants at room-level resolution. Outside the home, the same cellular telephones and global positioning system (GPS) technology were used to locate participants at a community-level resolution. Physical activity was simultaneously measured using the cellular telephone accelerometer. This approach had face validity to measure activity and lifespace. More importantly, this system could measure the spatial and temporal organization of these metrics. For example, an individual's lifespace was automatically calculated across multiple time intervals. Behavioral time budgets showing how people allocate time to specific regions within the home were also automatically generated. Mobile monitoring shows much promise as an easily deployed system to quantify activity and lifespace, important indicators of function, in community-dwelling adults. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Prevalence and predictors of depression among the elderly in ...

African Journals Online (AJOL)

Background: Geriatric depression is sometimes unrecognized by clinicians and often, depressive symptoms are attributed to the ageing process. The objective of this study was to determine the prevalence and predictors of depression in the elderly in selected rural communities in Delta State, Nigeria. Methods: This ...

A Telephone-based Physiotherapy Intervention for Patients with Osteoarthritis of the Knee

Science.gov (United States)

Odole, Adesola C.; Ojo, Oluwatobi D.

2013-01-01

This study assessed the effects of a 6-week telephone based intervention on the pain intensity and physical function of patients with knee osteoarthritis (OA), and compared the results to physiotherapy conducted in the clinic. Fifty randomly selected patients with knee OA were assigned to one of two treatment groups: a clinic group (CG) and a tele-physiotherapy group (TG). The CG received thrice-weekly physiotherapist administered osteoarthritis-specific exercises in the clinic for six weeks. The TG received structured telephone calls thrice-weekly at home, to monitor self-administered osteoarthritis-specific exercises. Participants’ pain intensity and physical function were assessed at baseline, two, four, and six weeks, in the clinic environment. Within group comparison showed significant improvements across baseline, and at weeks two, four, and six for both TG and CG’s pain intensity and physical function. Between-group comparison of CG and TG’s pain intensity and physical function at baseline and weeks two, four, and six showed no significant differences. This study demonstrated that a six-week course of structured telephone calls thrice-weekly to patients at their home, to monitor self-administered osteoarthritis-specific exercises for patients with knee OA (i.e., tele-physiotherapy) achieved comparable results to physiotherapy conducted in the clinic. PMID:25945214

Depression screening using the Patient Health Questionnaire-9 administered on a touch screen computer.

Science.gov (United States)

Fann, Jesse R; Berry, Donna L; Wolpin, Seth; Austin-Seymour, Mary; Bush, Nigel; Halpenny, Barbara; Lober, William B; McCorkle, Ruth

2009-01-01

To (1) evaluate the feasibility of touch screen depression screening in cancer patients using the Patient Health Questionnaire-9 (PHQ-9), (2) evaluate the construct validity of the PHQ-9 using the touch screen modality, and (3) examine the prevalence and severity of depression using this screening modality. The PHQ-9 was placed in a web-based survey within a study of the clinical impact of computerized symptom and quality of life screening. Patients in medical oncology, radiation oncology, and hematopoietic stem cell transplantation (HSCT) clinics used the program on a touch screen computer in waiting rooms prior to therapy (T1) and during therapy (T2). Responses of depressed mood or anhedonia (PHQ-2 cardinal depression symptoms) triggered additional items. PHQ-9 scores were provided to the oncology team in real time. Among 342 patients enrolled, 33 (9.6%) at T1 and 69 (20.2%) at T2 triggered the full PHQ-9 by endorsing at least one cardinal symptom. Feasibility was high, with at least 97% completing the PHQ-2 and at least 96% completing the PHQ-9 when triggered and a mean completion time of about 2 min. The PHQ-9 had good construct validity. Medical oncology patients had the highest percent of positive screens (12.9%) at T1, while HSCT patients had the highest percent (30.5%) at T2. Using this method, 21 (6.1%) at T1 and 54 (15.8%) at T2 of the total sample had moderate to severe depression. The PHQ-9 administered on a touch screen computer is feasible and provides valid depression data in a diverse cancer population. (c) 2008 John Wiley & Sons, Ltd.

[Motivational orientation and depressive symptoms in the elderly].

Science.gov (United States)

Altintas, E; Guerrien, A

2009-04-01

This article is focused on motivation and depression in later life. For about 20 years, research on the motivation of elders has underlined the importance of the cognitive evaluation of life contexts, notably in terms of self-determination. This cognitive evaluation determines the motivational orientation for daily activities (notably the levels of intrinsic and extrinsic motivation). The purpose of this research was specifically to study the relationships between the existence of four types of motivation (intrinsic, self-determined extrinsic, nonself-determined extrinsic and amotivation) and the consequences for adaptation and well-being. The study, therefore, focused on the possible links between motivation and geriatric-depression level and explored the nature of this link. Forty persons aged 60 or over (31 women: 80.48+/-9.24; nine men: 80.56+/-9.48) who live in nursing homes (20 elderly) or in their own homes (20 elderly) were enrolled. Elderly persons were assessed with specific and standardized tools: the Elderly Motivation Scale (EMS, in the French version: EMPA) and the Geriatric Depression Scale (GDS). For the statistical analyses of the results, correlations and Mann-Whitney test were used. We found that in elderly people, the motivational styles (the four types of motivation) can be reliably measured and are related to geriatric depression. First, significant positive links were noticed between intrinsic motivation and depression scores and between self-determined extrinsic motivation and depression scores. Conversely, significant negative links were noticed between nonself-determined extrinsic motivation and depression scores and between amotivation and depression scores. The most self-determined elders presented low-depression levels, whereas the more nonself-determined elders showed high-depression levels. Moreover, motivational styles significantly differed in the two groups (depressive or not depressive). The most depressive elders showed

Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection.

Science.gov (United States)

Gentry, Sarah; van-Velthoven, Michelle H M M T; Tudor Car, Lorainne; Car, Josip

2013-05-31

mode of communication, and whether underlying factors for change were altered. Meta-analyses, each of three studies, were performed for medication adherence and depressive symptoms. A narrative synthesis is presented for all other outcomes due to study heterogeneity. Out of 14 717 citations, 11 RCTs met the inclusion criteria (1381 participants).Six studies addressed outcomes relating to medication adherence, and there was some evidence from two studies that telephone interventions can improve adherence. A meta-analysis of three studies for which there was sufficient data showed no significant benefit (SMD 0.49, 95% CI -1.12 to 2.11). There was some evidence from a study of young substance abusing HIV positive persons of the efficacy of telephone interventions for reducing risky sexual behaviour, while a trial of older persons found no benefit. Three RCTs addressed virologic outcomes, and there is very little evidence that telephone interventions improved virologic outcomes. Five RCTs addressed outcomes relating to depressive and psychiatric symptoms, and showed some evidence that telephone interventions can be of benefit. Three of these studies which focussed on depressive symptoms were combined in a meta-analysis, which showed no significant benefit (SMD 0.02, 95% CI -0.18 to 0.21 95% CI). Telephone voice interventions may have a role in improving medication adherence, reducing risky sexual behaviour, and reducing depressive and psychiatric symptoms, but current evidence is sparse, and further research is needed.

Geriatric Helper: An mHealth Application to Support Comprehensive Geriatric Assessment

Directory of Open Access Journals (Sweden)

Samuel Silva

2018-04-01

Full Text Available The Comprehensive Geriatric Assessment (CGA is a multidisciplinary diagnosis approach that considers several dimensions of fragility in older adults to develop an individualized plan to improve their overall health. Despite the evidence of its positive impact, CGA is still applied by a reduced number of professionals in geriatric care in many countries, mostly using a paper-based approach. In this context, we collaborate with clinicians to bring CGA to the attention of more healthcare professionals and to enable its easier application in clinical settings by proposing a mobile application, Geriatric Helper, to act as a pocket guide that is easy to update remotely with up-to-date information, and that acts as a tool for conducting CGA. This approach reduces the time spent on retrieving the scales documentation, the overhead of calculating the results, and works as a source of information for non-specialists. Geriatric Helper is a tool for the health professionals developed considering an iterative, User-Centred Design approach, with extensive contributions from a broad set of users including domain experts, resulting in a highly usable and accepted system. Geriatric Helper is currently being tested in Portuguese healthcare units allowing for any clinician to apply the otherwise experts-limited geriatric assessment.

Depression in elderly primary health care clinic attendees in Ilorin ...

African Journals Online (AJOL)

Depression in the elderly presenting at primary care settings is usually under- detected by primary care physicians. This study assessed the prevalence of depression and the utility of the Geriatric Depression Scale (Short Form) in detecting depression in elderly patients in primary care populations in Ilorin, Nigeria. This was ...

The effect of telephone-based cognitive-behavioural therapy on parenting stress: A randomised controlled trial.

Science.gov (United States)

Ngai, Fei Wan; Wong, Paul Wai-Ching; Chung, Ka Fai; Leung, Kwok Yin

2016-07-01

Objective Stress related to parenting has detrimental effects on the well-being of children, parents and the family system as a whole. There are limited studies about the efficacy of cognitive-behavioural therapy delivered by telephone in reducing parenting stress. The present study investigates the effect of telephone-based cognitive-behavioural therapy on parenting stress at six weeks and six months postpartum. This is a multi-site randomised controlled trial. A total of 397 Chinese mothers at risk of postnatal depression were randomly assigned to receive either telephone-based cognitive-behavioural therapy or routine postpartum care. Parental stress was assessed by the Parenting Stress Index Short Form at six weeks and six months postpartum. The findings revealed that mothers who had received telephone-based cognitive-behavioural therapy showed significantly lower levels of parenting stress than women only receiving routine postpartum care at six weeks (mean difference=9.42, 95% confidence interval 5.85-12.99, pparenting and reducing stress during the transition period. Integration of telephone-based cognitive-behavioural therapy into routine postpartum care might facilitate positive adaptation in particular for mothers at risk of postnatal depression. Copyright © 2016. Published by Elsevier Inc.

Medications Associated with Geriatric Syndromes (MAGS) and their Prevalence in Older Hospitalized Adults Discharged to Skilled Nursing Facilities

Science.gov (United States)

Saraf, Avantika A.; Peterson, Alec W.; Simmons, Sandra F.; Schnelle, John F.; Bell, Susan P.; Kripalani, Sunil; Myers, Amy P.; Mixon, Amanda S.; Long, Emily A.; Jacobsen, J. Mary Lou; Vasilevskis, Eduard E.

2016-01-01

Background More than half of the hospitalized older adults discharged to skilled nursing facilities (SNFs) have more than three geriatric syndromes. Pharmacotherapy may be contributing to geriatric syndromes in this population. Objectives Develop a list of medications associated with geriatric syndromes and describe their prevalence in patients discharged from acute care to skilled nursing facilities (SNFs) Design Literature review and multidisciplinary expert panel discussion, followed by cross-sectional analysis. Setting Academic Medical Center in the United States Participants 154 hospitalized Medicare beneficiaries discharged to SNFs Measurements Development of a list of medications that are associated with six geriatric syndromes. Prevalence of the medications associated with geriatric syndromes was examined in the hospital discharge sample. Results A list of 513 medications was developed as potentially contributing to 6 geriatric syndromes: cognitive impairment, delirium, falls, reduced appetite or weight loss, urinary incontinence, and depression. Medications included 18 categories. Antiepileptics were associated with all syndromes while antipsychotics, antidepressants, antiparkinsonism and opioid agonists were associated with 5 geriatric syndromes. In the prevalence sample, patients were discharged to SNFs with an overall average of 14.0 (±4.7) medications, including an average of 5.9 (±2.2) medications that could contribute to geriatric syndromes, with falls having the most associated medications at discharge, 5.5 (±2.2). Conclusions Many commonly prescribed medications are associated with geriatric syndromes. Over 40% of all medications ordered upon discharge to SNFs were associated with geriatric syndromes and could be contributing to the high prevalence of geriatric syndromes experienced by this population. PMID:27255830

Development of Geriatric Mental Health Learning Objectives for Medical Students: A Response to the Institute of Medicine 2012 Report.

Science.gov (United States)

Lehmann, Susan W; Brooks, William B; Popeo, Dennis; Wilkins, Kirsten M; Blazek, Mary C

2017-10-01

America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students. The authors describe the development of a set of such learning objectives that all medical students should achieve by graduation. The iterative process included initial drafting by content experts from five medical schools with input and feedback from a wider group of geriatric psychiatrists, geriatricians, internists, and medical educators. The final document builds upon previously published work and includes specific knowledge, attitudes and skills in six key domains: Normal Aging, Mental Health Assessment of the Geriatric Patient, Psychopharmacology, Delirium, Depression, and Dementia. These objectives address a pressing need, providing a framework for national standards and curriculum development. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Why geriatrics? Academic geriatricians' perceptions of the positive, attractive aspects of geriatrics.

Science.gov (United States)

Cravens, D D; Campbell, J D; Mehr, D R

2000-01-01

Recruitment of geriatrics trainees has been poor, and the current shortage of academic geriatricians is expected to worsen. Although barriers to entering geriatrics practice have been identified, a review of the literature found few studies about why people choose to enter geriatrics. We used qualitative methods to investigate the positive, attractive aspects of geriatrics. Long interviews with six academic geriatricians were taped and transcribed. Transcripts were entered into a textual database computer program and reviewed independently by two investigators. Six themes emerged: 1) traditional learning experiences, 2) value on personal relationships, 3) a perception of distinctive differences, 4) a desire to feel needed personally and societally, 5) prefer democracy versus autocracy, and 6) desire intellectual challenges. Academic geriatrics, therefore, is particularly attractive to people who value enduring relationships, see challenges in complexity, practice social responsibility, prefer working within a multidisciplinary team, and derive satisfaction from making seemingly small but nonetheless important changes in peoples' lives. If further studies validate these findings, they could promote geriatrics as a career, by, for example, identifying students and family practice and internal medicine residents who share these values, beliefs, and attitudes and encouraging them to consider this important field.

Apathy in late-life depression: common, persistent, and disabling.

Science.gov (United States)

Yuen, Genevieve S; Bhutani, Saumya; Lucas, Bryony J; Gunning, Faith M; AbdelMalak, Bassem; Seirup, Joanna K; Klimstra, Sibel A; Alexopoulos, George S

2015-05-01

The aims of this study were to examine: (1) the relationship between apathy and disability in late-life depression, and (2) the functional significance of improvement in apathy following escitalopram treatment in terms of its relationship to disability. Subjects were 71 non-demented elderly with non-psychotic major depression. After a 2-week single-blind placebo period, subjects who had Hamilton Depression Rating Scale (HDRS) ≥ 18 received escitalopram 10 mg daily for 12 weeks. Apathy and disability were assessed with the Apathy Evaluation Scale (AES) and the World Health Organization Disability Assessment Scale II (WHODAS), respectively. These measures and the HDRS were administered at baseline and again following 12 weeks of treatment. At baseline, 38% of depressed subjects had significant apathy (AES ≥ 36.5). Severity of apathy at baseline significantly correlated with severity of disability. In a multivariate regression model, baseline severity of apathy, but not the overall depressive syndrome (HDRS), significantly correlated with baseline disability. Following escitalopram treatment, improvement in apathy significantly correlated with improvement in disability measures, while change in the rest of the depressive syndrome did not. The overall change in apathy and disability in response to escitalopram treatment was significant but small. Apathy is common in late-life depression and is associated with disability above and beyond the influence of other depressive symptoms. Given the strong relationship between apathy and disability, understanding the neurobiology of apathy and developing treatments for apathy may improve the functional outcomes of late-life depression. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

A randomized, controlled clinical trial of a geriatric consultation team. Compliance with recommendations.

Science.gov (United States)

Allen, C M; Becker, P M; McVey, L J; Saltz, C; Feussner, J R; Cohen, H J

1986-05-16

As part of a prospective, randomized, controlled study of the effectiveness of a geriatric consultation team, we examined compliance by the house staff with recommendations made by the team. Recommendations were formulated for 185 patients, aged 75 years or older, who were randomized into intervention (n = 92) and control (n = 93) groups. In the control group, only 27.1% of the actions that would have been recommended by the team were implemented independently by the house staff. Problems commonly neglected included polypharmacy, sensory impairment, confusion, and depression. In the intervention group, overall compliance was 71.7%. Highest compliance occurred for recommendations addressing instability and falls (95.0%) and discharge planning (94.3%). We conclude that a geriatric consultation team contributes substantial additional input into the care of older patients. Furthermore, relatively high compliance can be achieved with recommendations made by a geriatric consultation team, thereby overcoming the first barrier to the establishment of such a service.

Geriatric fall-related injuries.

African Journals Online (AJOL)

Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

Depression among older people in Sri Lanka: With special reference to ethnicity.

Science.gov (United States)

Khaltar, Amartuvshin; Priyadarshani, Neelawala Gw; Delpitiya, Nisansala Y; Jayasinghe, Chandrika; Jayasinghe, Ananda; Arai, Asuna; Tamashiro, Hiko

2017-12-01

To ascertain if the factors associated with depression differ among ethnic groups in community-dwelling older people in Kandy District, Sri Lanka. A cross-sectional survey was carried out of people aged ≥60 years living in a single divisional secretariat of Kandy District. The participants were asked about ethnicity (Sinhalese, Tamil and Muslim), sociodemographic characteristics and depression status by face-to-face interviews with a structured questionnaire. Depression was measured by the 15-item Geriatric Depression Scale, and the total score of ≥6 was considered as depression. The χ 2 -test and multivariate logistic regression with two-way interaction terms between sociodemographic characteristics and ethnicity were carried out. Participants (n = 778) consisted of 56.6% Sinhalese, 22.1% Tamils and 21.3% Muslims. Of the participants, the prevalence of depression was 31.8% (27.3% in Sinhalese, 42.1% in Tamils and 32.9% in Muslims). Multivariate analyses showed that there were no significant interactions between sociodemographic characteristics and ethnicity. However, low economic status, low perceived social support and more than two self-reported diseases were significantly associated with depression in all ethnic groups. Some factors were found to be significantly associated with depression, but did not differ among ethnic groups. The findings would help practitioners to identify older people with a high risk of depression, and to intervene in its development or exacerbation. Geriatr Gerontol Int 2017; 17: 2414-2420. © 2017 Japan Geriatrics Society.

A survey of the clinical acceptability of screening for postnatal depression in depressed and non-depressed women

Directory of Open Access Journals (Sweden)

Ericksen Jennifer

2006-08-01

Full Text Available Abstract Background Information on clinical acceptability is needed when making cost-utility decisions about health screening implementation. Despite being in use for two decades, most data on the clinical acceptability of the Edinburgh Postnatal Depression Scale (EPDS come from qualitative reports, or include relatively small samples of depressed women. This study aimed to measure acceptability in a survey of a relatively large, community sample with a high representation of clinically depressed women. Methods Using mail, telephone and face-to-face interview, 920 postnatal women were approached to take part in a survey on the acceptability of the EPDS, including 601 women who had screened positive for depression and 245 who had received DSM-IV diagnoses of depression. Acceptability was measured on a 5-point Likert scale of comfort ranging from "Not Comfortable", through "Comfortable" to "Very Comfortable". Results The response rate was just over half for postal surveys (52% and was 100% for telephone and face-to-face surveys (432, 21 and 26 respondents for postal, telephone and face-to-face surveys respectively making 479 respondents in total. Of these, 81.2% indicated that screening with the EPDS had been in the range of "Comfortable" to "Very Comfortable". The other 18.8 % rated screening below the "Comfortable" point, including a small fraction (4.3% who rated answering questions on the EPDS as "Not Comfortable" at the extreme end of the scale. Comfort was inversely related to EPDS score, but the absolute size of this effect was small. Almost all respondents (97% felt that screening was desirable. Conclusion The EPDS had good acceptability in this study for depressed and non-depressed women. Women's views on the desirability of postnatal depression screening appear to be largely independent of personal level of comfort with screening. These results should be useful to policy-makers and are broadly supportive of the Edinburgh Postnatal

International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

NARCIS (Netherlands)

Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L. G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

2014-01-01

Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the

National Database of Geriatrics

DEFF Research Database (Denmark)

Kannegaard, Pia Nimann; Vinding, Kirsten L; Hare-Bruun, Helle

2016-01-01

AIM OF DATABASE: The aim of the National Database of Geriatrics is to monitor the quality of interdisciplinary diagnostics and treatment of patients admitted to a geriatric hospital unit. STUDY POPULATION: The database population consists of patients who were admitted to a geriatric hospital unit....... Geriatric patients cannot be defined by specific diagnoses. A geriatric patient is typically a frail multimorbid elderly patient with decreasing functional ability and social challenges. The database includes 14-15,000 admissions per year, and the database completeness has been stable at 90% during the past......, percentage of discharges with a rehabilitation plan, and the part of cases where an interdisciplinary conference has taken place. Data are recorded by doctors, nurses, and therapists in a database and linked to the Danish National Patient Register. DESCRIPTIVE DATA: Descriptive patient-related data include...

A Telephone-based Physiotherapy Intervention for Patients with Osteoarthritis of the Knee

Directory of Open Access Journals (Sweden)

Adesola C Odole

2013-12-01

Full Text Available This study assessed the effects of a 6-week telephone based intervention on the pain intensity and physical function of patients with knee osteoarthritis (OA, and compared the results to physiotherapy conducted in the clinic. Fifty randomly selected patients with knee OA were assigned to one of two treatment groups: a clinic group (CG and a tele-physiotherapy group (TG. The CG received thrice-weekly physiotherapist administered osteoarthritis-specific exercises in the clinic for six weeks. The TG received structured telephone calls thrice-weekly at home, to monitor self-administered osteoarthritis-specific exercises. Participants’ pain intensity and physical function were assessed at baseline, two, four, and six weeks, in the clinic environment. Within group comparison showed significant improvements across baseline, and at weeks two, four, and six for both TG and CG’s pain intensity and physical function. Between-group comparison of CG and TG’s pain intensity and physical function at baseline and weeks two, four, and six showed no significant differences. This study demonstrated that a six-week course of structured telephone calls thrice-weekly to patients at their home, to monitor self-administered osteoarthritis-specific exercises for patients with knee OA (i.e., tele-physiotherapy achieved comparable results to physiotherapy conducted in the clinic.   12.00 Normal 0 false false false EN-US X-NONE X-NONE

A profile of acute care in an aging America: snowball sample identification and characterization of United States geriatric emergency departments in 2013.

Science.gov (United States)

Hogan, Teresita M; Olade, Tolulope Oyeyemi; Carpenter, Christopher R

2014-03-01

The aging of America poses a challenge to emergency departments (EDs). Studies show that elderly patients have poor outcomes despite increased testing, prolonged periods of observation, and higher admission rates. In response, emergency medicine (EM) leaders have implemented strategies for improved ED elder care, enhancing expertise, equipment, policies, and protocols. One example is the development of geriatric EDs gaining in popularity nationwide. To the authors' knowledge, this is the first research to systematically identify and qualitatively characterize the existence, locations, and features of geriatric EDs across the United States. The primary objective was to determine the number, distribution, and characteristics of geriatric EDs in the United States in 2013. This was a survey with potential respondents identified via a snowball sampling of known geriatric EDs, EM professional organizations' geriatric interest groups, and a structured search of the Internet using multiple search engines. Sites were contacted by telephone, and those confirming geriatric EDs presence received the survey via e-mail. Category questions included date of opening, location, volumes, staffing, physical plant changes, screening tools, policies, and protocols. Categories were reported based on general interest to those seeking to understand components of a geriatric ED. Thirty-six hospitals confirmed geriatric ED existence and received surveys. Thirty (83%) responded to the survey and confirmed presence or plans for geriatric EDs: 24 (80%) had existing geriatric EDs, and six (20%) were planning to open geriatric EDs by 2014. The majority of geriatric EDs are located in the Midwest (46%) and Northeast (30%) regions of the United States. Eighty percent serve from 5,000 to 20,000 elder patients annually. Seventy percent of geriatric EDs are attached to the main ED, and 66% have from one to 10 geriatric beds. Physical plant changes include modifications to beds (96%), lighting (90

Physical activity and depression in older adults with and without cognitive impairment.

Science.gov (United States)

Yuenyongchaiwat, Kornanong; Pongpanit, Khajonsak; Hanmanop, Somrudee

2018-01-01

Low physical activity and depression may be related to cognitive impairment in the elderly. To determine depression and physical activity (PA) among older adults with and without cognitive impairment. 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

Health, Social, and Economic Variables Associated with Depression Among Older People in Low and Middle Income Countries: World Health Organization Study on Global AGEing and Adult Health.

Science.gov (United States)

Brinda, Ethel M; Rajkumar, Anto P; Attermann, Jǿrn; Gerdtham, Ulf G; Enemark, Ulrika; Jacob, Kuruthukulangara S

2016-12-01

Although depression among older people is an important public health problem worldwide, systematic studies evaluating its prevalence and determinants in low and middle income countries (LMICs) are sparse. The biopsychosocial model of depression and prevailing socioeconomic hardships for older people in LMICs have provided the impetus to determine the prevalence of geriatric depression; to study its associations with health, social, and economic variables; and to investigate socioeconomic inequalities in depression prevalence in LMICs. The authors accessed the World Health Organization Study on Global AGEing and Adult Health Wave 1 data that studied nationally representative samples from six large LMICs (N = 14,877). A computerized algorithm derived depression diagnoses. The authors assessed hypothesized associations using survey multivariate logistic regression models for each LMIC and pooled their risk estimates by meta-analyses and investigated related socioeconomic inequalities using concentration indices. Cross-national prevalence of geriatric depression was 4.7% (95% CI: 1.9%-11.9%). Female gender, illiteracy, poverty, indebtedness, past informal-sector occupation, bereavement, angina, and stroke had significant positive associations, whereas pension support and health insurance showed significant negative associations with geriatric depression. Pro-poor inequality of geriatric depression were documented in five LMICs. Socioeconomic factors and related inequalities may predispose, precipitate, or perpetuate depression amongolder people in LMICs. Relative absence of health safety net places socioeconomically disadvantaged older people in LMICs at risk. The need for population-based public health interventions and policies to prevent and to manage geriatric depression effectively in LMICs cannot be overemphasized. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Depression in an older adult rural population in India.

Science.gov (United States)

Sinha, Sati P; Shrivastava, Saurabh R; Ramasamy, Jegadeesh

2013-10-01

With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. In India, increased life expectancy led to a rise in the older adult population between 2001 and 2011, expected to reach 324 million by 2050. To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community. A cross-sectional descriptive study was conducted in February and March 2012 in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of 5948, 3.1% of whom are aged ≥60 years. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent (a thumbprint was taken if the person was illiterate), participants were assessed face to face for depression using the Short Form Geriatric Depression Scale. The inclusion criterion was a score >24 on the mini-mental state examination. Final sample size was 103. Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version 17. Of 103 respondents interviewed, 73 (70.9%) were aged 60-69 years and 58 (56.3%) were male. Forty-four (42.7%) individuals (17 males, 27 females) were found to be depressed; 23 (22.3%) with mild depression, 14 (13.6%) moderate depression and 7 (6.8%) severe depression. Female sex and widowhood were significantly associated with depression. Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more

Geriatric Cardiology: An Emerging Discipline.

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Dodson, John A; Matlock, Daniel D; Forman, Daniel E

2016-09-01

Given changing demographics, patients with cardiovascular (CV) disease in developed countries are now older and more complex than even a decade ago. This trend is expected to continue into the foreseeable future; accordingly, cardiologists are encountering patients with a greater number of comorbid illnesses as well as "geriatric conditions," such as cognitive impairment and frailty, which complicate management and influence outcomes. Simultaneously, technological advances have widened the therapeutic options available for patients, including those with the most advanced CV disease. In the setting of these changes, geriatric cardiology has recently emerged as a discipline that aims to adapt principles from geriatric medicine to everyday cardiology practice. Accordingly, the tasks of a "geriatric cardiologist" may include both traditional evidence-based CV management plus comprehensive geriatric assessment, medication reduction, team-based coordination of care, and explicit incorporation of patient goals into management. Given that the field is still in its relative infancy, the training pathways and structure of clinical programs in geriatric cardiology are still being delineated. In this review, we highlight the rationale behind geriatric cardiology as a discipline, several current approaches by geriatric cardiology programs, and future directions for the field. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Short Term Group Counseling of Visually Impaired People by Telephone.

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Jaureguy, Beth M.; Evans, Ron L.

1983-01-01

Short term group counseling via the telephone resulted in marked increases in activities of daily living among 12 legally blind veterans. Many subjects' personal coping goals were met as well, and social involvement also increased. No significant changes in levels of depression or agitation were noted. (CL)

Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study.

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Kool, Jan; Oesch, Peter; Bachmann, Stefan

2017-01-01

OBJECTIVE To evaluate patient characteristics predicting living at home after geriatric rehabilitation. DESIGN Prospective cohort study. PATIENTS A total of 210 patients aged 65 years or older receiving inpatient rehabilitation. METHODS Candidate predictors evaluated during rehabilitation were: age, vulnerability (Vulnerable Elders Survey), multimorbidity (Cumulative Illness Rating Scale), cognition (Mini-Mental State Examination), depression (Hospital Anxiety and ...

PREVALENCE OF OCCULT DEPRESSION IN ELDERLY WITH CHRONIC CO - MORBIDS

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Sachin

2015-02-01

Full Text Available BACKGROUND: Growth in elderly population has led to an increase in age related diseases and mainly depression which is affecting the quality of life. Depression is more prevalent amongst elderly individuals with medical illnesses and emerging public health problem leading to increased morbidity and disability worldwide. AIMS AND OBJE CTIVES: To assess the prevalence of occult depression in elderly patients with chronic co - morbid medical conditions. MATERIALS AND METHODS: It was a cross - sectional study conducted in tertiary hospital. Total 100 elderly patients with underlying chronic me dical illnesses were included. Depression in study population was assessed by geriatric depression scale and analyzed. RESULT: Out of 100 patients 23(23% had depression. Females 12/39(30.76% were affected more than males 11/61 (18.03%. Depression was mo re prevalent among patients with 3 or more co - morbid conditions (45.4% as compared to <3 (11.9%. CONCLUSION: Elderly patients with multiple chronic medical illnesses may have associated occult depression. Screening of these patients for depression couple d with appropriate psychiatric referral should be an integral part of Geriatric service

Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele-Interpersonal Psychotherapy for HIV-infected Rural Persons: Evidence for Indirect Effects.

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Anderson, Timothy; McClintock, Andrew S; McCarrick, Shannon S; Heckman, Timothy G; Heckman, Bernadette D; Markowitz, John C; Sutton, Mark

2018-03-01

Interpersonal psychotherapy (IPT) has demonstrated efficacy for the treatment of depression, yet little is known about its therapeutic mechanisms. As a specific treatment, IPT has been shown to directly reduce depressive symptoms, although it is unclear whether these reductions occur via interpersonal changes. Within IPT, the potential role of the working alliance, a common factor, as a predictor of depression and interpersonal changes is also unclear. Participants were 147 depressed persons living with HIV in rural communities of 28 U.S. states enrolled in a randomized clinical trial. Seventy-five patients received up to 9 sessions of telephone-administered IPT (tele-IPT) plus standard care and 72 patients received standard care only. Two models were tested; one included treatment condition (tele-IPT vs. control) and another included the working alliance as independent variables. The first model found an indirect effect whereby tele-IPT reduced depression via decreased social avoidance. There was a direct effect between tele-IPT and reduced depression. In the second model, the working alliance influenced depressive symptom relief via reductions in social avoidance. Both goal and task working alliance subscales were indirectly associated with reductions in depressive symptoms, also through reductions in social avoidance. There were no direct effects involving the working alliance. Tele-IPT's influence on depressive symptom reduction was primarily through a direct effect, whereas the influence of working alliance depression was almost entirely via an indirect effect through interpersonal problems. Study findings have implications for IPT when intervening with depressed rural people living with HIV/AIDS over the telephone. © 2017 Wiley Periodicals, Inc.

Diagnosis and management of geriatric insomnia: a guide for nurse practitioners.

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Krishnan, Preetha; Hawranik, Pamela

2008-12-01

To discuss the assessment, diagnosis, and management of geriatric insomnia, a challenging clinical condition of older adults frequently seen by primary care providers. Extensive literature review of the published research articles and textbooks. Complaints of insomnia among older adults are frequently ignored, considered a part of the normal aging process or viewed as a difficult to treat condition. Geriatric insomnia remains a challenge for primary care providers because of the lack of evidence-based clinical guidelines and limited treatment options available. Effective management of this condition is necessary for improved quality of life, which is a primary issue for the elderly and their families. Therefore, geriatric insomnia warrants thorough attention from the nurse practitioners (NPs) who provide care for older adults. Undiagnosed or under treated insomnia can cause increased risk for falls, motor vehicle accidents, depression, and shorter survival. Insomniacs double their risk for cardiovascular disease, stroke, cancer, and suicide compared to their counterparts. Insomnia is also associated with increased healthcare utilization and institutionalization. NPs could play a central role in reducing the negative consequences of insomnia through a systematic approach for diagnosis, evaluation, and management.

Pain-induced depression in the elderly: Validation of psychometric properties of the Brazilian version of the "Geriatric Emotional Assessment of Pain" - GEAP-b.

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Almeida, Carla Bezerra Lopes; Félix, Ricardo Humberto; Cendoroglo, Maysa Seabra; Santos, Fania Cristina

2017-09-01

In order to introduce an instrument within our midst that allows a comprehensive clinical evaluation of pain-induced depression in the elderly, we proposed the translation, cross-cultural adaptation into Brazilian Portuguese, and study of the psychometric properties of the "Geriatric Psychosocial Assessment of Pain-induced Depression" (GEAP) scale. This instrument was especially developed for the screening of depression associated with chronic pain in the elderly. We performed translation and cross-cultural adaptation of the GEAP scale, whose psychometric properties were analyzed in a sample of 48 elderly individuals. Sociodemographic data and information related to chronic pain were ascertained, as well as those related to depression. The GEAP-b scale was applied at three different times on the same day by two different interviewers (I1 and I2), and after 15 days by one of those interviewers (I3). The GEAP-b proved to be an easy-to-apply instrument with a high internal consistency value, according to the Cronbach's alpha coefficient (0.835). The reproducibility of the instrument was optimal, achieving intraclass correlations of 98.5 and 92% for interobserver and intraobserver, respectively. There was "considerable" agreement (between 0.419 and 1.0) for each GEAP-b item, except for item 19, according to the kappa statistic. As for the validity of the GEAP-b criterion, positive and statistically significant correlations were obtained for pain, according to GPM-p (r=49.5%, pdepression, according to GDS (r=59%, pdepression in the elderly.

Comparison of in-person and telephone administration of the Mini-Mental State Examination in the University of Alabama at Birmingham Study of Aging.

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Kennedy, Richard E; Williams, Courtney P; Sawyer, Patricia; Allman, Richard M; Crowe, Michael

2014-10-01

To validate the Mini-Mental State Examination (MMSE) Telephone (MMSET) against the MMSE. Cross-sectional. Homes of community-dwelling older adults. African-American and non-Hispanic white adults aged 75 and older participating in the University of Alabama at Birmingham Study of Aging II, a longitudinal epidemiological study across the state of Alabama (N = 419). Cognition, measured using the MMSE, MMSET, and Six-Item Screener (SIS), and function, based on self-reported difficulty performing instrumental activities of daily living (IADLs). Correlation and agreement coefficients were used to examine concordance of the MMSE and MMSET; linear and logistic regressions were used to test associations with clinical outcomes of IADL difficulty and verified diagnoses of dementia. The MMSET showed good internal consistency (Cronbach α = 0.845), similar to the full MMSE, and strong correlation with the latter (Spearman ρ = 0.694, P < .001). The MMSET explained a similar proportion of IADL difficulty as the full MMSE (coefficient of variation = 0.201 and 0.189, respectively). The MMSET was also associated with verified dementia diagnoses (area under the receiver operating characteristic curve = 0.73), which was similar to the full MMSE. The MMSET is a brief, valid measure of cognition in older adults with psychometric properties similar to that of the full MMSE. Because it can be administered over the telephone, further use in epidemiological studies is promising. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials.

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Dèttore, Davide; Pozza, Andrea; Andersson, Gerhard

2015-01-01

Cognitive behavioural therapy (CBT) is a well-established treatment for obsessive-compulsive disorder (OCD). However, few patients receive CBT, due to factors such as geographic limitations, perceived stigmatization, and lack of CBT services. Technology-delivered cognitive behavioural therapy (T-CBT) could be an effective strategy to improve patients' access to CBT. To date, a meta-analysis on the effectiveness of T-CBT for OCD has not been conducted. This study used meta-analytic techniques to summarize evidence on the efficacy of T-CBT for OCD versus control conditions and therapist-administered CBT. A meta-analysis according to Prisma guidelines was conducted on randomized controlled trials (RCTs) of T-CBT for OCD. Treatment was classified as T-CBT if evidence-based CBT active ingredients for OCD were included (psychoeducation, ERP, and cognitive restructuring), delivered through health technologies (e.g. self-help books, leaflets, and other forms of bibliotherapy) or remote communication technologies (e.g. the Internet, web-cameras, telephones, telephone-interactive voice response systems, and CD-ROMS). Studies using validated outcomes for OCD or depression were included. Eight trials were included (N = 420). Two trials were classified as at high risk of bias. T-CBT seemed to be superior to control conditions on OCD symptom outcomes at post-treatment (d = 0.82, 99% CI = 0.55-1.08, p = 0.001), but not on comorbid depression (d = 0.33, 99% CI = - 0.01-0.67, p = 0.020). Difference in the efficacy on OCD symptoms between T-CBT and therapist-administered CBT was not significant, despite a trend favouring therapist-administered CBT emerged (d = 0.45, 95% CI = 0.03-0.87, p = 0.033). Directions for research are discussed. Further RCTs are warranted to examine the efficacy of T-CBT for OCD.

Findings regarding the relationships between sociodemographic, psychological, comorbidity factors, and functional status, in geriatric inpatients.

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Capisizu, Ana; Aurelian, Sorina; Zamfirescu, Andreea; Omer, Ioana; Haras, Monica; Ciobotaru, Camelia; Onose, Liliana; Spircu, Tiberiu; Onose, Gelu

2015-01-01

To assess the impact of socio-demographic and comorbidity factors, and quantified depressive symptoms on disability in inpatients. Observational cross-sectional study, including a number of 80 elderly (16 men, 64 women; mean age 72.48 years; standard deviation 9.95 years) admitted in the Geriatrics Clinic of "St. Luca" Hospital, Bucharest, between May-July, 2012. We used the Functional Independence Measure, Geriatric Depression Scale and an array of socio-demographic and poly-pathology parameters. Statistical analysis included Wilcoxon and Kruskal-Wallis tests for ordinal variables, linear bivariate correlations, general linear model analysis, ANOVA. FIM scores were negatively correlated with age (R=-0.301; 95%CI=-0.439 -0.163; p=0.007); GDS scores had a statistically significant negative correlation (R=-0.322; 95% CI=-0.324 -0.052; p=0.004) with FIM scores. A general linear model, including other variables (gender, age, provenance, matrimonial state, living conditions, education, respectively number of chronic illnesses) as factors, found living conditions (p=0.027) and the combination of matrimonial state and gender (p=0.004) to significantly influence FIM scores. ANOVA showed significant differences in FIM scores stratified by the number of chronic diseases (p=0.035). Our study objectified the negative impact of depression on functional status; interestingly, education had no influence on FIM scores; living conditions and a combination of matrimonial state and gender had an important impact: patients with living spouses showed better functional scores than divorced/widowers; the number of chronic diseases also affected the FIM scores: lower in patients with significant polypathology. These findings should be considered when designing geriatric rehabilitation programs, especially for home--including skilled--cares.

Co-creation by the ABIM Geriatric Medicine Board and the AGS - Helping Move Geriatrics Forward.

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Leff, Bruce; Lundjeberg, Nancy E; Brangman, Sharon A; Dubow, Joyce; Levine, Sharon; Morgan-Gouveia, Melissa; Schlaudecker, Jeffrey; Lynn, Lorna; McDonald, Furman S

2017-10-01

The American board of internal medicine (ABIM) establishes standards for physicians. The American geriatrics society (AGS) is a not-for-profit membership organization of nearly 6,000 health professionals devoted to improving the health, independence, and quality of life of all older people. Beginning in 2013, ABIM redesigned its governance structure, including the role of the specialty boards. Specialty boards are charged with responsibilities for oversight in four main areas: (1) the assessments used in initial certification and maintenance of certification (MOC); (2) medical knowledge self-assessment and practice assessment in the specialty; (3) building relationships with relevant professional societies and other organizational stakeholders; and (4) issues related to training requirements for initial certification eligibility within the specialty. The aim of this paper is to inform the geriatrics community regarding the function of geriatric medicine board (GMB) of the ABIM, and to invite the geriatrics community to fully engage with and leverage the GMB as a partner to: (1) develop better certification examinations and processes, identifying better knowledge and practice assessments, and in establishing appropriate training and MOC requirements for geriatric medicine; (2) leverage ABIM assets to conduct applied research to guide the field in the areas of training and certification and workforce development in geriatric medicine; (3) make MOC relevant for practicing geriatricians. Active engagement of the geriatrics community with ABIM and the GMB will ensure that certification in geriatric medicine provides the greatest possible value and meaning to physicians, patients, and the public. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Longitudinal Association of Dementia and Depression.

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Snowden, Mark B; Atkins, David C; Steinman, Lesley E; Bell, Janice F; Bryant, Lucinda L; Copeland, Catherine; Fitzpatrick, Annette L

2015-09-01

Depression is an important precursor to dementia, but less is known about the role dementia plays in altering the course of depression. We examined whether depression prevalence, incidence, and severity are higher in those with dementia versus those with mild cognitive impairment (MCI), or normal cognition. Prospective cohort study using the longitudinal Uniform Data Set of the National Alzheimer's Coordinating Center (2005-2013). 34 Alzheimer Disease research centers. 27,776 subjects with dementia, MCI, or normal cognition. Depression status was determined by a clinical diagnosis of depression within the prior 2 years and by a Geriatric Depression Scale-Short Form score >5. Rates of depression were significantly higher in subjects with MCI and dementia compared with those with normal cognition at index visit. Controlling for demographics and common chronic conditions, logistic regression analysis revealed elevated depression in those with MCI (OR: 2.40 [95% CI: 2.25, 2.56]) or dementia (OR: 2.64 [95% CI: 2.43, 2.86]) relative to those with normal cognition. In the subjects without depression at the index visit (N = 18,842), those with MCI and dementia had higher probabilities of depression diagnosis 2 years post index visit than those with normal cognition: MCI = 21.7%, dementia = 24.7%, normal cognition = 10.5%. MCI and dementia were associated with significantly higher rates of depression in concurrent as well as prospective analyses. These findings suggest that efforts to effectively engage and treat older adults with dementia will need also to address co-occurring depression. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Rationale and methods of the multicenter randomised trial of a heart failure management programme among geriatric patients (HF-Geriatrics

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Casado Jose

2011-08-01

Full Text Available Abstract Background Disease management programmes (DMPs have been shown to reduce hospital readmissions and mortality in adults with heart failure (HF, but their effectiveness in elderly patients or in those with major comorbidity is unknown. The Multicenter Randomised Trial of a Heart Failure Management Programme among Geriatric Patients (HF-Geriatrics assesses the effectiveness of a DMP in elderly patients with HF and major comorbidity. Methods/Design Clinical trial in 700 patients aged ≥ 75 years admitted with a primary diagnosis of HF in the acute care unit of eight geriatric services in Spain. Each patient should meet at least one of the following comorbidty criteria: Charlson index ≥ 3, dependence in ≥ 2 activities of daily living, treatment with ≥ 5 drugs, active treatment for ≥ 3 diseases, recent emergency hospitalization, severe visual or hearing loss, cognitive impairment, Parkinson's disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD, anaemia, or constitutional syndrome. Half of the patients will be randomly assigned to a 1-year DMP led by a case manager and the other half to usual care. The DMP consists of an educational programme for patients and caregivers on the management of HF, COPD (knowledge of the disease, smoking cessation, immunizations, use of inhaled medication, recognition of exacerbations, diabetes (knowledge of the disease, symptoms of hyperglycaemia and hypoglycaemia, self-adjustment of insulin, foot care and depression (knowledge of the disease, diagnosis and treatment. It also includes close monitoring of the symptoms of decompensation and optimisation of treatment compliance. The main outcome variables are quality of life, hospital readmissions, and overall mortality during a 12-month follow-up. Discussion The physiological changes, lower life expectancy, comorbidity and low health literacy associated with aging may influence the effectiveness of DMPs in HF. The HF-Geriatrics study

Intellectual function, activities of daily living and computerized tomography of the brain in geriatric demented patients

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Omura, Fumiaki; Ogura, Chikara; Kishimoto, Akira; Okubo, Masayo; Imamoto, Atsushi [Tottori Univ., Yonago (Japan). School of Medicine; Tsuchie, Harutaka; Sugihara, Kanichiro; Fujii, Shozo

1984-09-01

Thirty eight patients of geriatric dementia (mean age 74.9 years) were examined by computerized tomography (CT) and their intellectual functions and activities of daily living (ADL) were evaluated. CT was evaluated by both visual assessment method and direct measuring method. Intellectual function was evaluated by Jikei University dementia rating scale. ADL was evaluated by both Hasegawa's rating scale and Sengoku's rating scale. Results were as follows: significant influence by age was observed in intellectual functions and ADL of subjects above 75 years old. There were good correlations between the higher intellectual function, the better grooming and hygiene, and less needs of nursing care. The severe brain atrophy evaluated by the visual assessment method was correlated with the depressed level of intellectual function. When brain atrophy is mild despite high degree of dementia, reexamination should be made to explore somatic diseases inducing depression of mental activity. It also should be noted that sex and age difference is important in studying geriatric patients.

Intellectual function, activities of daily living and computerized tomography of the brain in geriatric demented patients

International Nuclear Information System (INIS)

Omura, Fumiaki; Ogura, Chikara; Kishimoto, Akira; Okubo, Masayo; Imamoto, Atsushi; Tsuchie, Harutaka; Sugihara, Kanichiro; Fujii, Shozo.

1984-01-01

Thirty eight patients of geriatric dementia (mean age 74.9 years) were examined by computerized tomography (CT) and their intellectual functions and activities of daily living (ADL) were evaluated. CT was evaluated by both visual assessment method and direct measuring method. Intellectual function was evaluated by Jikei University dementia rating scale. ADL was evaluated by both Hasegawa's rating scale and Sengoku's rating scale. Results were as follows: significant influence by age was observed in intellectual functions and ADL of subjects above 75 years old. There were good correlations between the higher intellectual function, the better grooming and hygiene, and less needs of nursing care. The severe brain atrophy evaluated by the visual assessment method was correlated with the depressed level of intellectual function. When brain atrophy is mild despite high degree of dementia, reexamination should be made to explore somatic diseases inducing depression of mental activity. It also should be noted that sex and age difference is important in studying geriatric patients. (author)

Research on current situations of geriatric nursing education

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Liu Yujin

2017-01-01

Full Text Available The population aging is accelerating and the aging population is growing in China. Although the geriatric nursing education has been developed for more than 20 years, geriatric nursing professionals are still insufficient and the geriatric nursing education is facing various challenges under the new situation. This paper primarily describes the developmental history and the related concepts of geriatric nursing education, and analyzes the personnel training modes and routes of geriatric nursing education, and its problems, in order to provide the basis for the reform of geriatric nursing education. The development of geriatric nursing needs a large number of outstanding nursing personnel, and the cultivation of geriatric nursing professionals depends on the development of geriatric nursing and the improvement of the teaching quality of geriatric nursing education. Front-line educators working on geriatric nursing should be committed to reforming the geriatric nursing teaching, improving the teaching quality and cultivating the high-quality nursing personnel suitable for conditions of the elderly in China.

Analysis of cytopenia in geriatric inpatients.

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Röhrig, G; Becker, I; Pappas, K; Polidori, M C; Schulz, R J

2018-02-01

.5%. In 70.8% of the study patients PPIs were administered but the indication for PPI administration remained unclear in 20.4%. The results encourage accurate assessment of blood dyscrasias and appropriate documentation as well as indication check for PPI treatment in geriatric inpatients.

Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease.

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Cheung, Gary; Patrick, Colin; Sullivan, Glenda; Cooray, Manisha; Chang, Catherina L

2012-01-01

Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population. Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale. Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%. Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression.

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Llewellyn-Jones, R H; Baikie, K A; Castell, S; Andrews, C L; Baikie, A; Pond, C D; Willcock, S M; Snowdon, J; Tennant, C C

2001-12-01

To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.

Geriatric imaging

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Guglielmi, Giuseppe [Scientific Institute Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Italy). Dept. of Radiology; Peh, Wilfred C.G. [Khoo Teck Puat Hospital, Singapore (Singapore). Dept. of Diagnostic Radiology; Guermazi, Ali (eds.) [Boston Univ. School of Medicine, Boston, MA (United States). Dept. of Radiology

2013-08-01

Considers all aspect of geriatric imaging. Explains clearly how to distinguish the healthy elderly from those in need of treatment. Superbly illustrated. Written by recognized experts in field. In the elderly, the coexistence of various diseases, the presence of involutional and degenerative changes, and the occurrence of both physical and cognitive problems represent ''the norm.'' It is therefore important to know how to distinguish the healthy elderly from those in need of treatment as a sound basis for avoiding overdiagnosis and overtreatment. This aspect is a central theme in Geriatric Imaging, which covers a wide range of applications of different imaging techniques and clearly explains both the potential and the limitations of diagnostic imaging in geriatric patients. Individual sections are devoted to each major region or system of the body, and a concluding section focuses specifically on interventional procedures. The book, written by recognized experts in the field, is superbly illustrated and will be an ideal resource for geriatricians, radiologists, and trainees.

Controlling urinary tract infections associated with intermittent bladder catheterization in geriatric hospitals.

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Girard, R; Gaujard, S; Pergay, V; Pornon, P; Martin Gaujard, G; Vieux, C; Bourguignon, L

2015-07-01

Controlling urinary tract infections (UTIs) associated with intermittent catheterization in geriatric patients. After a local epidemiological study identified high rates of UTI, a multi-disciplinary working group implemented and evaluated corrective measures. In 2009, a one-month prospective study measured the incidence of UTI, controlled for risk factors and exposure, in six geriatric hospitals. In 2010, a self-administered questionnaire on practices was administered to physicians and nurses working in these geriatric units. In 2011, the working group developed a multi-modal programme to: improve understanding of micturition, measurement of bladder volume and indications for catheter drainage; limit available medical devices; and improve prescription and traceability procedures. Detailed training was provided to all personnel on all sites. The epidemiological study was repeated in 2012 to assess the impact of the programme. Over 1500 patients were included in the 2009 study. The incidence of acquired infection was 4.8%. The infection rate was higher in patients with intermittent catheters than in patients with indwelling catheters (29.7 vs 9.9 UTI per 100 patients, P = 0.1013) which contradicts the literature. In 2010, the 269 responses to the questionnaire showed that staff did not consider catheterization to place patients at risk of infection, staff had poor knowledge of the recommended indications and techniques, and the equipment varied widely between units. Following implementation of the programme, the study was repeated in 2012 with over 1500 patients. The frequency of UTI in patients with intermittent catheters fell to rates in the published literature. Multi-modal programmes are an effective means to control UTI. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Endodontic treatment in geriatric patients

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Milly Armilya Andang

2007-11-01

Full Text Available With the increased number of geriatric population, it is predicted that the need for dental treatment also increases. The needs for esthetic factors and function of geriatric patient are maybe similar to young patient. The number of geriatric patients who refuse dental extraction is increasing if there are still other alternative. They can be more convinced when the clinician said that the dental disease experienced is a focal infection so that the loss of the tooth can be accepted as the best option. But if it is possible, they will prefer endodontic treatment, because they want to keep their teeth according to the treatment plan or based on patient's request, as a less traumatic alternative compared to extraction.Endodontic treatment consideration for geriatric patient is quite similar to younger patients. The technique is also the same, although the problem may be bigger. The problem or obstacle that may arise in endodontic treatment for geriatric patient relates to the visit duration, problems during x-ray, problems in defining root canal location, vertical root fracture, and in some cases, decreased pulp tissue recovery ability. Due to the fact that the challenge is quite big, the success of endodontic treatment in geriatric patients needs to be considered. This paper will explain the endodontic treatment prognosis for geriatric patients.

Anxiety, depression, and fall-related psychological concerns in community-dwelling older people.

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Hull, Samantha L; Kneebone, Ian I; Farquharson, Lorna

2013-12-01

Establish the association between affect and fall-related psychological concerns (fear of falling, fall-related self-efficacy, balance confidence, and outcome expectancy). A total of 205 community-dwelling older people (mean age 81, SD 7.5 years) completed the Geriatric Depression Scale-15, Geriatric Anxiety Inventory, Modified Survey of Activities and Fear of Falling, Falls-Efficacy Scale- International, Activity-Specific Balance Confidence Scale, and the Consequences of Falling Scale. Hierarchical regression models showed that anxiety was independently associated with all fall-related psychological concerns; depression was only associated with falls efficacy. Associations between fall-related psychological concerns and age, gender, accommodation,medications, self-rated physical health, falls history, mobility, and sensory aids are also discussed. This is the first study that investigates the association between affect and the four fall-related psychological concerns. Anxiety was a significant factor associated with all four, whereas depression was only associated with activity avoidance. Implications for healthcare providers are discussed. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Behavioral activation for dementia caregivers: scheduling pleasant events and enhancing communications

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Au A

2015-03-01

Full Text Available Alma Au,1,2 Dolores Gallagher-Thompson,3 Meng-Kong Wong,4 Jess Leung,4 Wai-Chi Chan,5 Chun Chung Chan,6 Hui-Jing Lu,1 Man Kin Lai,1 Kevin Chan11Department of Applied Social Sciences, 2Institute of Active Aging, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China; 3Department of Psychiatry and Behavioral Sciences and Geriatric Education Centre, School of Medicine, Stanford University, Stanford, CA, USA; 4Department of Psychiatry, United Christian Hospital, 5Department of Psychiatry, University of Hong Kong, 6Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, People’s Republic of ChinaBackground: Dementia caregiving is often associated with increase in depressive symptoms and strained relationships. This study tested whether telephone-delivered psychoeducation combined with an enhanced behavioral activation (BA module had a better effect on the well-being of Alzheimer’s caregivers than psychoeducation alone. The focus is on enhancing the competent use of coping skills via BA. The program is delivered by telephone to increase accessibility and sustainability for caregivers. Senior citizens are trained as paraprofessionals to deliver the BA module to increase the potential for sustainability of the program.Methods and subjects: The study compared two telephone interventions using a 4-month longitudinal randomized controlled trial. For the first 4 weeks, all participants received the same psychoeducation program via telephone. Then for the following 4 months, eight biweekly telephone follow-up calls were carried out. For these eight follow-up calls, participants were randomized into either one of the two following groups with different conditions. For the psychoeducation with BA (PsyED-BA group, participants received eight biweekly sessions of BA practice focused on pleasant event scheduling and improving communications. For the psychoeducation only (PsyED only group, participants received

Comparison of Lumbosacral Alignment in Geriatric and Non-Geriatric patients suffering low back pain.

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Kocyigit, Burhan Fatih; Berk, Ejder

2018-01-01

Lumbosacral alignment is a crucial factor for an appropriate spinal function. Changes in spinal alignment lead to diminished body biomechanics. Additionally, lumbosacral alignment may affect quality of life, sagittal balance and fall risk in elderly. In this study, we aimed to compare lumbosacral alignment in geriatric and non-geriatric patients suffering from low back pain. A total of 202 (120 male and 82 female) patients who visited to physical medicine and rehabilitation clinic with low back pain between January 2017 and August 2017 were enrolled in this study. Standing lateral lumbar radiographs were obtained from the electronic hospital database. Lumbar lordosis angle, sacral tilt, lumbosacral angle and lumbosacral disc angle were calculated on lateral standing lumbar radiographs. The mean age of the non-geriatric group was 43.02 ± 13.20 years, the geriatric group was 71.61 ± 6.42 years. In geriatric patients, lumbar lordosis angle, sacral tilt and lumbosacral disc angle were significantly smaller (p = 0.042, p = 0.017 and p = 0.017). No significant differences were observed in lumbosacral angle between the groups (p = 0.508). Our study indicates the specific changes in lumbosacral alignment with aging. Identifying these changes in lumbosacral alignment in the geriatric population will enable to create proper rehabilitation strategies.

Does cognitive-behavioural therapy promote meaning making? A preliminary test in the context of geriatric depression.

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Holland, Jason M; Chong, Gabriella; Currier, Joseph M; O'Hara, Ruth; Gallagher-Thompson, Dolores

2015-03-01

This study examined the extent to which cognitive-behavioural therapy (CBT) for geriatric depression promoted meaning made of stress. Fifty-one participants received CBT and were assessed at pre- and post-treatment. The primary outcome was the Integration of Stressful Life Experiences Scale (ISLES) and demographic factors were examined as moderators of changes over time. Those with more education showed improvement in their ability to regain positive values, worldviews, and purpose in life after a stressor. It appears that CBT promotes some forms of meaning made of stress for those with higher education. Cognitive-behavioural therapy as it is routinely practiced may help highly educated older adults regain their Footing in the World (e.g., maintain positive values, worldviews, and purpose in life) in the aftermath of a stressful life event. Cognitive-behavioural therapy appears to offer fewer gains for less educated older adults (in terms of Footing in the World) as well as for other aspects of meaning-making, such as the ability to 'make sense' of a significant stressor. Although more empirical work is necessary, meaning-oriented interventions (e.g., 're-authoring' a fragmented self-narrative; Neimeyer, 2009, p. 97) hold promise as useful adjuncts to routine therapy that could augment outcomes. © 2014 The British Psychological Society.

Evaluation of geriatric changes in dogs

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Pati, Soumyaranjan; Panda, S. K.; Acharya, A. P.; Senapati, S.; Behera, M.; Behera, S. S.

2015-01-01

Aim: The present study has been envisaged to ascertain the old age for critical management of geriatric dogs considering the parameters of externally visible changes, haemato-biochemical alterations and urine analysis in geriatric dogs approaching senility. Materials and Methods: The study was undertaken in the Department of Veterinary Pathology in collaboration with Teaching Veterinary Clinic complex spanning a period of 1 year. For screening of geriatric dogs, standard geriatric age chart o...

Efficacy and experiences of telephone counselling for informal carers of people with dementia.

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Lins, Sabine; Hayder-Beichel, Daniela; Rücker, Gerta; Motschall, Edith; Antes, Gerd; Meyer, Gabriele; Langer, Gero

2014-09-01

Informal carers of people with dementia can suffer from depressive symptoms, emotional distress and other physiological, social and financial consequences. This review focuses on three main objectives:To:1) produce a quantitative review of the efficacy of telephone counselling for informal carers of people with dementia;2) synthesize qualitative studies to explore carers' experiences of receiving telephone counselling and counsellors' experiences of conducting telephone counselling; and3) integrate 1) and 2) to identify aspects of the intervention that are valued and work well, and those interventional components that should be improved or redesigned. The Cochrane Dementia and Cognitive Improvement Group's Specialized Register, The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, PSYNDEX, PsycINFO, Web of Science, DIMDI databases, Springer database, Science direct and trial registers were searched on 3 May 2011 and updated on 25 February 2013. A Forward Citation search was conducted for included studies in Web of Science and Google Scholar. We used the Related Articles service of PubMed for included studies, contacted experts and hand-searched abstracts of five congresses. Randomised controlled trials (RCTs) or cross-over trials that compared telephone counselling for informal carers of people with dementia against no treatment, usual care or friendly calls for chatting were included evaluation of efficacy. Qualitative studies with qualitative methods of data collection and analysis were also included to address experiences with telephone counselling. Two authors independently screened articles for inclusion criteria, extracted data and assessed the quantitative trials with the Cochrane 'Risk of bias' tool and the qualitative studies with the Critical Appraisal Skills Program (CASP) tool. The authors conducted meta-analyses, but reported some results in narrative form due to clinical heterogeneity. The authors synthesised the qualitative data and

Validação da escala de depressão geriátrica em um ambulatório geral Validation of geriatric depression scale in a general outpatient clinic

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Emylucy Martins Paiva Paradela

2005-12-01

Full Text Available OBJETIVO: A Escala de Depressão Geriátrica, utilizada para o rastreamento de sintomas depressivos em idosos, ainda não teve suas características de medida avaliadas em ambulatórios gerais no Brasil. O objetivo foi estudar a validade da Escala, com 15 itens (EDG-15, na identificação de episódio de Depressão Maior ou Distimia em idosos atendidos em ambulatório geral. MÉTODOS: A Escala foi aplicada em 302 indivíduos com 65 anos ou mais, que em seguida foram examinados, de maneira independente, por um geriatra que não tinha conhecimento dos resultados da Escala. Os diagnósticos de Depressão Maior ou Distimia foram feitos utilizando-se os critérios do Diagnostic and Statistical Manual of Mental Disorders-IV. A sensibilidade e a especificidade nos vários pontos de corte foram expressas pela curva Receiver Operating Characteristic. RESULTADOS: O ponto de corte de melhor equilíbrio foi 5/6, obteve sensibilidade de 81% e especificidade de 71%; e o valor da área sob a curva Receiver Operating Characteristic foi de 0,85 (IC 95%: 0,79-0,91. CONCLUSÕES: A Escala de Depressão Geriátrica pode ser utilizada para o rastreamento de sintomas depressivos na população geriátrica ambulatorial brasileira. O ponto de corte 5/6, sugerido inicialmente por outros autores, mostrou-se adequado.OBJECTIVE: The Geriatric Depression Scale for screening depressive symptoms in the elderly has not been assessed in elderly outpatients who seek primary health care in Brazil. The objective was to determine the validity of the Short Scale for Major Depressive Episode or Dysthymia (GDS-15 in elderly outpatients. METHODS: The scale was applied in 302 subjects with 65 years and older and then examined by an independent geriatrician, blinded to the results. Major depression and dysthymia were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Sensitivity and specificity were calculated at several cutoff values and a Receiver

Prevalence and Predictors of Geriatric Depression in Community-Dwelling Elderly

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Jeung-Im Kim, RN, PhD

2009-09-01

Conclusion: In this research, perceived health status was the most powerful predictor of elderly depression. TMIG-IC, hand-grip strength and social activities also predicted Korean elderly depression. These factors should be considered when the program is developed for elderly people with depression. [Asian Nursing Research 2009;3(3:121–129

Vitamin D and depression in geriatric primary care patients

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Lapid MI

2013-05-01

Full Text Available Maria I Lapid,1 Stephen S Cha,2 Paul Y Takahashi31Division of Outpatient Consultation, Department of Psychiatry and Psychology, 2Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, 3Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USAPurpose: Vitamin D deficiency is common in the elderly. Vitamin D deficiency may affect the mood of people who are deficient. We investigated vitamin D status in older primary care patients and explored associations with depression.Patients and methods: A cross-sectional study was conducted and association analyses were performed. Primary care patients at a single academic medical center who were ≥60 years with serum total 25-hydroxyvitamin D (25[OH]D levels were included in the analysis. The primary outcome was a diagnosis of depression. Frailty scores and medical comorbidity burden scores were collected as predictors.Results: There were 1618 patients with a mean age of 73.8 years (±8.48. The majority (81% had optimal (≥25 ng/mL 25(OHD range, but 17% met mild-moderate (10–24 ng/mL and 3% met severe (<10 ng/mL deficiencies. Those with severe deficiency were older (P < 0.001, more frail (P < 0.001, had higher medical comorbidity burden (P < 0.001, and more frequent depression (P = 0.013. The 694 (43% with depression had a lower 25(OHD than the nondepressed group (32.7 vs 35.0, P = 0.002. 25(OHD was negatively correlated with age (r = −0.070, P = 0.005, frailty (r = −0.113, P < 0.001, and medical comorbidity burden (r = −0.101, P < 0.001. A 25(OHD level was correlated with depression (odds ratio = 0.990 and 95% confidence interval [CI] = 0.983–0.998, P = 0.012. Those with severe vitamin D deficiency were twice as likely to have depression (odds ratio = 2.093 with 95% CI 1.092–4.011, P = 0.026.Conclusion: Vitamin D deficiency was present in a fifth of this older primary care population. Lower vitamin D levels

Use of Ketamine in Elderly Patients with Treatment-Resistant Depression.

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Medeiros da Frota Ribeiro, Carolina; Riva-Posse, Patricio

2017-11-15

The purpose of this paper is to provide a review of the use of ketamine as an antidepressant for treatment-resistant depression (TRD) in the geriatric population. Available treatment options for late-life treatment-resistant depression are limited and include electroconvulsive therapy and transcranial magnetic stimulation as well as possible pharmacologic augmentation. Ketamine has been shown to be a promising treatment in TRD; however, data regarding the use of ketamine in the elderly includes only five case reports. We discuss the use of ketamine for late-life TRD and present two cases where ketamine led to a significant and sustained improvement in depressive symptoms. Ketamine is a promising treatment for geriatric patients with TRD. Further studies in the elderly will provide valuable insights into the use of ketamine for a population much in need of safe and effective treatments for TRD.

Análise da sintomatologia depressiva nos moradores do Abrigo Cristo Redentor através da aplicação da Escala de Depressão Geriátrica (EDG Analysis of depression in elderly living in the shelter " Christ the Redeemer" , applying the Scale of Geriatric Depression (SGD

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Gisela Rocha de Siqueira

2009-02-01

Full Text Available O objetivo do estudo foi determinar a prevalência de depressão em idosos que residem no Abrigo Cristo Redentor, Jaboatão dos Guararapes, Pernambuco. Foi realizado estudo descritivo no período de setembro e outubro de 2006, com idosos de idade igual ou acima de 60 anos. A amostra foi composta de 55 idosos, que responderam à Escala de Depressão Geriátrica de Yesavage, com trinta perguntas. Foram realizadas análises de variância da prevalência dos sintomas de depressão entre ambos os sexos. A depressão foi identificada em 28 idosos (51%, dentre os quais dezoito homens (64,3% e dez mulheres (35,7%. Recomenda-se a criação de uma nova escala, mais simples e de entendimento mais fácil, para pacientes que têm nível cognitivo rebaixado.The objective of this study was to determine the prevalence of depression in elderly living in the shelter " Christ the Redeemer" , in Jaboatão dos Guararapes, Pernambuco. A descriptive study was conducted in September and October 2006, with individuals aged 60 years or more. The sample consisted of 55 elderly, who answered the 30 questions of the Scale of Geriatric Depression of Yesavage. Analysis of variance of the prevalence of depression symptoms between both sexes was conducted. Depression was identified in 28 individuals (51%, 18 males (64,2% and 10 females (35,7%. We recommend the creation of a new scale, simpler and easier to understand for patients with lower cognitive level.

Assessment of Depression in Elderly. Is Perceived Social Support Related? A Nursing Home Study : Depression and Social Support in Elderly.

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Patra, Paraskevi; Alikari, Victoria; Fradelos, Evangelos C; Sachlas, Athanasios; Kourakos, Michael; Rojas Gil, Andrea Paola; Babatsikou, Fotoula; Zyga, Sofia

2017-01-01

Geriatric depression is more common in nursing homes and social support is a mechanism that mitigates the stressors of life factors and simultaneously promotes wellness and health. The purpose of the study was to assess the levels of depression and social support among elderly in nursing homes. During the period February 2016-March 2016 170 elderly residents in nursing homes completed the Geriatric Depression Scale-15 (GDS-15) and the Multidimensional Scale of Perceived Social Support (MSPSS). Statistical analysis was conducted with IBM SPSS Statistics 23. 37, 1% of the sample had depressive symptoms. Depression is statistically correlated with age and it is affected by the years of education (p = 0.003), the number of the children (p = 0.006), whether the elderly person is bedridden or not (p elderly performs activities outside the nursing home (0.001). Higher GDS score had those who were illiterate (6.41), those with one or no children (6.82 and 6.59 respectively), the bedridden (6.70), people without visits from relatives (7.69) and without activities outside (5.64). Also, social support is affected by the family status (p elderly performs activities outside the foundation (p elderly population leads to the need for more aid social support.

The social network index and its relation to later-life depression among the elderly aged ≥80 years in Northern Thailand.

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Aung, Myo Nyein; Moolphate, Saiyud; Aung, Thin Nyein Nyein; Katonyoo, Chitima; Khamchai, Songyos; Wannakrairot, Pongsak

2016-01-01

Having a diverse social network is considered to be beneficial to a person's well-being. The significance, however, of social network diversity in the geriatric assessment of people aged ≥80 years has not been adequately investigated within the Southeast Asian context. This study explored the social networks belonging to the elderly aged ≥80 years and assessed the relation of social network and geriatric depression. This study was a community-based cross-sectional survey conducted in Chiang Mai Province, Northern Thailand. A representative sample of 435 community residents, aged ≥80 years, were included in a multistage sample. The participants' social network diversity was assessed by applying Cohen's social network index (SNI). The geriatric depression scale and activities of daily living measures were carried out during home visits. Descriptive analyses revealed the distribution of SNI, while the relationship between the SNI and the geriatric depression scale was examined by ordinal logistic regression models controlling possible covariants such as age, sex, and educational attainment. The median age of the sample was 83 years, with females comprising of 54.94% of the sample. The participants' children, their neighbors, and members of Buddhist temples were reported as the most frequent contacts of the study participants. Among the 435 participants, 25% were at risk of social isolation due to having a "limited" social network group (SNI 0-3), whereas 37% had a "medium" social network (SNI 4-5), and 38% had a "diverse" social network (SNI ≥6). The SNI was not different among the two sexes. Activities of daily living scores in the diverse social network group were significantly higher than those in the limited social network group. Multivariate ordinal logistic regression analysis models revealed a significant negative association between social network diversity and geriatric depression. Regular and frequent contact with various social contacts may

Predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge

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Johari N

2016-10-01

Full Text Available Nuruljannah Johari,1 Zahara Abdul Manaf,1 Norhayati Ibrahim,2 Suzana Shahar,1 Norlaila Mustafa3 1Dietetics Programme, 2Health Psychology Programme, Faculty of Health Sciences, 3Medical Department, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Purpose: Diabetes mellitus is prevalent among older adults, and affects their quality of life. Furthermore, the number is growing as the elderly population increases. Thus, this study aims to explore the predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge in Malaysia. Methods: A total of 110 hospitalized geriatric patients aged 60 years and older were selected using convenience sampling method in a cross-sectional study. Sociodemographic data and medical history were obtained from the medical records. Questionnaires were used during the in-person semistructured interviews, which were conducted in the wards. Linear regression analyses were used to determine the predictors of each domain of quality of life. Results: Multiple regression analysis showed that activities of daily living, depression, and appetite were the determinants of physical health domain of quality of life (R2=0.633, F(3, 67=38.462; P<0.001, whereas depression and instrumental activities of daily living contributed to 55.8% of the variability in psychological domain (R2=0.558, F(2, 68=42.953; P<0.001. Social support and cognitive status were the determinants of social relationship (R2=0.539, F(2, 68=39.763; P<0.001 and also for the environmental domain of the quality of life (R2=0.496, F(2, 68=33.403; P<0.001. Conclusion: The findings indicated different predictors for each domain in the quality of life among hospitalized geriatric patients with diabetes mellitus. Nutritional, functional, and psychological aspects should be incorporated into rehabilitation support programs prior to discharge in order to improve patients�

COMMON DRUGS ADMINISTERED FOR DEPRESSION IN CHILDREN AND ADOLESCENTS: A CLINIC - BASED STUDY IN NOOR HOSPITAL (1996-98

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M MAROOFI

2002-12-01

Full Text Available Introduction. There are increasing interests about pharmacotherapy in depressed children and adolescents. Althought TCAs (such as imipramine are approved for use in enuresis and ADHD, but controlled studies have failed to demonstrate efficacy of them over placebo in the treatment of depressive disorders in both children or adolescents. On the other hand, a relatively more amount of studies address SSRls (such as fluoxetine, as the drug of choice for treatment of depressed children and adolescents, because of theire effectiveness and safety.
Methods. In this retrospective study, 306 depressed child and adolescent (7-18 year old who admitted to a psychiatric out patient clinic were studied (196 male and 110 female. Imipramine and fluoxetin were administered for 47 percent and 43 percent of cases, respectively.
Results. In imipramin geoup and fluoxetine group the symptoms of 126 (87 percent and 102 (77 percent patient was improved, respectively. The frequency of side effects was 21 percent for imipramin (specialy sedation, dizziness and palpitation and 22 percent for fluoxatine (specially headache, insomnia and agitation.
Discussion. This study suggests that both imipramin and fluoxetine are efficient for tratment of children and adolescents depression. However, because of high theraputic index of fluoxetine, this drug may be a better choice.

Evaluation and Comparison of Cognitive State and Depression in Elderly Admitted in Sanitarium with Elderly Sited in Personal Home

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Mohamad-baghere Sohrabi; Pone Zolfaghari; Farzane Mahdizade; Seyd-Mohammad Aghayan; Mojtaba Ghasemian- Aghmashhadi; Zahra Shariati; Ahmad Khosravi

2008-01-01

Introduction: In this study cognitive state and geriatric depression in elderly living in sanatorium and personal home were evaluated. Methods: The present study was conducted on 46 aged subjects living in sanitarium and 90 aged subjects staying in personal homes. Mini mental status examination (MMSE) and geriatric depression scale (GDS) questionnaires were completed according to the standard examination. Results: As for the cognitive state of the aged living in sanitarium, 13 cases (28.3%) s...

Recognition of geriatric popular song repertoire: a comparison of geriatric clients and music therapy students.

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VanWeelden, Kimberly; Cevasco, Andrea M

2010-01-01

The purposes of the current study were to determine geriatric clients' recognition of 32 popular songs and songs from musicals by asking whether they: (a) had heard the songs before; (b) could "name the tune" of each song; and (c) list the decade that each song was composed. Additionally, comparisons were made between the geriatric clients' recognition of these songs and by music therapy students' recognition of the same, songs, based on data from an earlier study (VanWeelden, Juchniewicz, & Cevasco, 2008). Results found 90% or more of the geriatric clients had heard 28 of the 32 songs, 80% or more of the graduate students had heard 20 songs, and 80% of the undergraduates had heard 18 songs. The geriatric clients correctly identified 3 songs with 80% or more accuracy, which the graduate students also correctly identified, while the undergraduates identified 2 of the 3 same songs. Geriatric clients identified the decades of 3 songs with 50% or greater accuracy. Neither the undergraduate nor graduate students identified any songs by the correct decade with over 50% accuracy. Further results are discussed.

Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression.

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Aubert, Ronald E; Fulop, George; Xia, Fang; Thiel, Melinda; Maldonato, Debra; Woo, Cindy

2003-05-01

To evaluate the impact of telephone counseling and educational materials on medication adherence and persistency among members with newly diagnosed depression enrolled in a pharmacy benefit management-sponsored disease management program. Longitudinal cohort observation. The study population comprised 505 members with a new or recurrent episode of depression who consented and enrolled in a depression disease management program. After written consent was obtained, program participants received up to 4 telephone-counseling calls and 5 educational mailings focused on the importance of medication compliance, barriers to medication compliance, quality of life, symptoms, and satisfaction with the program. A control group of 3744 members was selected from client companies that opted not to offer the depression program. Measures of medication adherence, persistency with prescription drug therapy, and patient refill timeliness were computed for both groups and compared. Patients enrolled in the depression disease management program were significantly more likely to adhere to their medication regimen during acute (89.0% vs 67.7%, P management-sponsored health management depression program succeeded in encouraging patients with new or recurrent depression to stay on antidepressant medication and to reach treatment goals outlined by best practice guidelines.

Pain-induced depression in the elderly: Validation of psychometric properties of the Brazilian version of the “Geriatric Emotional Assessment of Pain” - GEAP-b

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Carla Bezerra Lopes Almeida

Full Text Available Summary Objective: In order to introduce an instrument within our midst that allows a comprehensive clinical evaluation of pain-induced depression in the elderly, we proposed the translation, cross-cultural adaptation into Brazilian Portuguese, and study of the psychometric properties of the “Geriatric Psychosocial Assessment of Pain-induced Depression” (GEAP scale. This instrument was especially developed for the screening of depression associated with chronic pain in the elderly. Method: We performed translation and cross-cultural adaptation of the GEAP scale, whose psychometric properties were analyzed in a sample of 48 elderly individuals. Sociodemographic data and information related to chronic pain were ascertained, as well as those related to depression. The GEAP-b scale was applied at three different times on the same day by two different interviewers (I1 and I2, and after 15 days by one of those interviewers (I3. Results: The GEAP-b proved to be an easy-to-apply instrument with a high internal consistency value, according to the Cronbach’s alpha coefficient (0.835. The reproducibility of the instrument was optimal, achieving intraclass correlations of 98.5 and 92% for interobserver and intraobserver, respectively. There was “considerable” agreement (between 0.419 and 1.0 for each GEAP-b item, except for item 19, according to the kappa statistic. As for the validity of the GEAP-b criterion, positive and statistically significant correlations were obtained for pain, according to GPM-p (r=49.5%, p<0.001, and depression, according to GDS (r=59%, p<0.001, both values being considered regular (between 40-60%. Conclusion: The GEAP-b scale has proven to be reliable and valid in the screening of pain-related depression in the elderly.

American Association for Geriatric Psychiatry

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... Position Statements Publications Bookstore American Journal of Geriatric Psychiatry Legislative & Regulatory Agenda AAGP eNews (Members Only) Tools ... Funding Training Resources and Curricula For Clinicians >> Geriatric Psychiatry Identifier Webinar: Billing and Coding Consumer Material Clinical ...

Telephone Crisis Support Workers' Intentions to Use Recommended Skills While Experiencing Functional Impairment.

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Kitchingman, Taneile A; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-05-01

Empathic engagement with distressed others can lead to elevated symptoms of psychological distress and functional impairment, which preclude helping professionals' delivery of optimal patient care. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. This study examined the relationship between functional impairment and intentions to use recommended support skills in a representative national sample of 210 telephone crisis support workers. Participants completed an online survey including measures of functional impairment and intentions to use recommended telephone crisis support skills with callers reporting suicidal ideation, symptoms of depression, and anxiety. As a group, participants who experienced greater functional impairment during the past month reported significantly lower intentions to use recommended support skills with callers than those who reported lower functional impairment. Future research is needed to clarify the extent to which results generalize to telephone crisis support workers from other organizations. Results warrant further research to (a) identify determinants of telephone crisis support workers' functional impairment, and (b) for the deliberate management of telephone crisis support workers' functional impairment through developing and/or modifying existing service strategies to optimize workers' psychological well-being and delivery of support to callers.

Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

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Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

2013-01-01

Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

Readability and Comprehension of the Geriatric Depression Scale and PROMIS® Physical Function Items in Older African Americans and Latinos.

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Paz, Sylvia H; Jones, Loretta; Calderón, José L; Hays, Ron D

2017-02-01

Depression and physical function are particularly important health domains for the elderly. The Geriatric Depression Scale (GDS) and the Patient-Reported Outcomes Measurement Information System (PROMIS ® ) physical function item bank are two surveys commonly used to measure these domains. It is unclear if these two instruments adequately measure these aspects of health in minority elderly. The aim of this study was to estimate the readability of the GDS and PROMIS ® physical function items and to assess their comprehensibility using a sample of African American and Latino elderly. Readability was estimated using the Flesch-Kincaid and Flesch Reading Ease (FRE) formulae for English versions, and a Spanish adaptation of the FRE formula for the Spanish versions. Comprehension of the GDS and PROMIS ® items by minority elderly was evaluated with 30 cognitive interviews. Readability estimates of a number of items in English and Spanish of the GDS and PROMIS ® physical functioning items exceed the U.S. recommended 5th-grade threshold for vulnerable populations, or were rated as 'fairly difficult', 'difficult', or 'very difficult' to read. Cognitive interviews revealed that many participants felt that more than the two (yes/no) GDS response options were needed to answer the questions. Wording of several PROMIS ® items was considered confusing, and interpreting responses was problematic because they were based on using physical aids. Problems with item wording and response options of the GDS and PROMIS ® physical function items may reduce reliability and validity of measurement when used with minority elderly.

Psychomotor Retardation in untreated depressed elderly

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Lieve Lia Beheydt

2015-01-01

Full Text Available Background: Psychomotor retardation (PR is one of the core features in depression according to 17 DSM V1, but also aging in itself causes cognitive and psychomotor slowing. This is the first study 18 investigating psychomotor retardation in relation to cognitive functioning and to the concomitant 19 effect of depression and aging in a geriatric population ruling out contending effects of psychotropic 20 medication. Methods: A group of 28 non-demented depressed elderly is compared to a matched 21 control group of 20 healthy elderly. All participants underwent a test battery containing clinical 22 depression measures, cognitive measures of processing speed, executive function and memory, 23 clinical ratings of psychomotor retardation and objective computerized fine motor skill-tests. 24 Statistical analysis consisted of a General Linear Method (GLM multivariate analysis of variance to 25 compare the clinical, cognitive and psychomotor outcomes of the two groups. Results: Patients 26 performed worse on all clinical, cognitive and psychomotor retardation measures. Both groups 27 showed an effect of cognitive load on fine motor function but the influence was significantly larger 28 for patients than for healthy elderly except for the initiation time. Limitations: due to the restrictive 29 inclusion criteria, only a relatively limited sample size could be obtained. Conclusion: With a 30 medication free sample, an additive effect of depression and aging on cognition and PR in geriatric 31 patients was found,. As this effect was independent of demand of effort (by varying the cognitive 32 load, it was apparently not a motivational slowing effect of depression.

Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

Directory of Open Access Journals (Sweden)

Jennifer C. Reneker

2016-10-01

Full Text Available This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen’s d-values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15–0.30. Two perceptions of geriatric physical therapy demonstrated a significant positive increase (P<0.05 with moderate effect sizes (d=0.47 and d=0.50. The students’ perceptions of geriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68 and enjoyment (d=1.96. Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

Music therapy for institutionalised elderly persons with depression

Directory of Open Access Journals (Sweden)

Amal Dev

2015-01-01

Full Text Available The geriatric population of India accounts more than six per cent of the total population. The number of elderly in Kerala is expected to reach 7.2 million by 2021 and 11.9 millions in 2051. The present study was conducted to (a assess the level of depressive symptom in institutionalised elderly persons before and after the music therapy, and (b to evaluate the effect of music therapy on depressive symptoms in elderly. An experimental research design with a one group pre-test post-test design was adopted. The purposive sample consisted of 40 elderly with depressive symptom. The tools used were (a a proforma to collect socio-demographic data, (b Geriatric Depression Scale, (c Mini Mental Status Examination, and (d Beck’s Depression Inventory. Each of the selected samples was given music therapy through individual walkman for 30 minutes in the evening hours for a regular period of 21 days. Post test was conducted a week after the completion of this exercise. There was a significant reduction in the depressive symptoms before and after the experiment (t=3.65, p<0.001. The study has major implication in the mental health practice, education, administration, and research. It’s a cost-effective and safe nursing intervention proven effective in reducing depressive symptoms. Applying music therapy shall augment the effect of alternative therapies and to apply it, there is no need for the nursing professionals to undergo any additional training.

Understanding implementation of comprehensive geriatric care programs: a multiple perspective approach is preferred

OpenAIRE

Vos, J.B.M.; Cramm, Jane; Wijngaarden, Jeroen; Bakker, Ton; Mackenbach, Johan; Nieboer, Anna

2017-01-01

Summary Background The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital‐related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2–0.6]), lower depression (Geriatric Depressio...

[Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (ÖGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013].

Science.gov (United States)

Singler, K; Stuck, A E; Masud, T; Goeldlin, A; Roller, R E

2014-11-01

Sound knowledge in the care and management of geriatric patients is essential for doctors in almost all medical subspecialties. Therefore, it is important that pregraduate medical education adequately covers the field of geriatric medicine. However, in most medical faculties in Europe today, learning objectives in geriatric medicine are often substandard or not even explicitly addressed. As a first step to encourage undergraduate teaching in geriatric medicine, the European Union of Medical Specialists -Geriatric Medicine Section (UEMS-GMS) recently developed a catalogue of learning goals using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end of their studies.In order to ease the implementation of this new, competence-based curriculum among the medical faculties in universities teaching in the German language, the authors translated the published English language curriculum into German and adapted it according to medical language and terms used at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties adapt their curricula for undergraduate teaching based on this catalogue.

Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students' perceptions of geriatrics and geriatric education in the United States.

Science.gov (United States)

Reneker, Jennifer C; Weems, Kyra; Scaia, Vincent

2016-01-01

This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21-33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen's d values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15-0.30). Two perceptions of geriatric physical therapy demonstrated a significant positive increase (Pgeriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68) and enjoyment (d=1.96). Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

Telephone Exchange Maintenance

CERN Multimedia

2005-01-01

Urgent maintenance work on CERN telephone exchanges will be performed on 24 March from 6 a.m. to 8 a.m. Telephone services may be disrupted or even interrupted during this time. For more details, please contact us by email at Standard.Telephone@cern.ch.

Prevalence and Predictors of Depression among the Elderly in ...

African Journals Online (AJOL)

UNIBEN

1Department of Community Medicine, College of Health Sciences, Delta State University, Abraka, Delta State. ... Background: Geriatric depression is sometimes unrecognized by clinicians and often, ..... Ann Med Sci. Res 2012; 2: 10-13. 11.

The Effects of Integrative Reminiscence Therapy on Signs and Symptoms of Depression in the Elderly

Directory of Open Access Journals (Sweden)

Asghar Mohammadzadeh

2011-04-01

Full Text Available Objectives: The Main aim of this study was to determine the effects of integrative reminiscence therapy on signs and symptoms of depression in the institutionalized elderly. Methods & Materials: This study was an experimental study with pre-test and post-test along with control group. The statistical society in this study consisted of all elderly adults residing in centers of Isfahan. Sample selection style was simple random sampling. The Geriatric Depression Scale (GDS and Mini Mental Status Examination (MMSE were primarily administered and the scores of higher than ten in GDS (severe and moderate depression and higher than twenty one in MMSE were identified and a number of 36 subjects were randomly selected and were randomly divided into two groups, 18 participants to experiment group and 18 participants to the control group. Results: The analysis of the results was performed using independent t-test and chisquare. Mean of the difference of pretest and posttest results was acquired in experimental group (M=2.5385, SD=0.87706and control group (M=1, SD=0.93541. Conclusion: The results of this study suggest that integrative reminiscence therapy can significantly result in reducing depression signs and symptoms in older adults. This intervention can serve as a supplementary treatment along with pharmaceutical treatment.

Differentiation between mild cognitive impairment, Alzheimer's disease and depression by means of cued recall.

Science.gov (United States)

Dierckx, E; Engelborghs, S; De Raedt, R; De Deyn, P P; Ponjaert-Kristoffersen, I

2007-05-01

Discriminating Alzheimer's disease (AD) and mild cognitive impairment (MCI) from depression is a challenge in psychogeriatric medicine. A study was set up to ascertain whether cued recall could be useful in differentiating early AD and MCI from depression among elderly individuals. The Visual Association Test (VAT) and the Memory Impairment Screen-plus (MIS-plus) were administered together with the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) to 40 MCI patients, 35 mild AD patients, 46 depressed patients and 52 healthy control subjects. A one-way analysis of variance (ANOVA) followed by post-hoc Scheffé tests showed that AD patients had significantly lower cued recall scores (i.e. combined VAT and MIS-plus scores) than MCI patients, who in turn had lower scores than depressed patients. The scores of depressed patients and controls were not significantly different. Discriminant analysis revealed that 94% of the AD patients and 96% of the depressed patients could be classified correctly by means of the GDS and the cued recall sores. Receiver operating characteristic (ROC) curves identified an optimal cut-off score of 8 (maximum score 12) for differentiating AD and MCI patients from depressed elderly patients and controls. Applying this cut-off, a sensitivity of 83% (58%) and a specificity of 85% (85%) was obtained when differentiating AD (MCI) from depression. Cued recall, operationalized by the combined scores of VAT and MIS-plus, is a useful method for differentiating AD patients from depressed individuals and healthy controls. Probably because of the great heterogeneity among MCI patients, the diagnostic power of cued recall decreases when applied to differentiate MCI from depression.

Depressive symptoms are associated with daytime sleepiness and subjective sleep quality in dementia with Lewy bodies.

Science.gov (United States)

Elder, Greg J; Colloby, Sean J; Lett, Debra J; O'Brien, John T; Anderson, Kirstie N; Burn, David J; McKeith, Ian G; Taylor, John-Paul

2016-07-01

Sleep problems and depression are common symptoms in dementia with Lewy bodies (DLB), where patients typically experience subjectively poor sleep quality, fatigue and excessive daytime sleepiness. However, whilst sleep disturbances have been linked to depression, this relationship has not received much attention in DLB. The present cross-sectional study addresses this by examining whether depressive symptoms are specifically associated with subjective sleep quality and daytime sleepiness in DLB, and by examining other contributory factors. DLB patients (n = 32) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the 15-item Geriatric Depression Scale (GDS-15). Motor and cognitive functioning was also assessed. Pearson correlations were used to assess the relationship between GDS-15, ESS and PSQI scores. GDS-15 scores were positively associated with both ESS (r = 0.51, p depressive symptoms in DLB. Given the cross-sectional nature of the present study, the directionality of this relationship cannot be determined, although this association did not appear to be mediated by sleep quality or daytime sleepiness. Nevertheless, these findings have clinical relevance; daytime sleepiness or poor sleep quality might indicate depression in DLB, and subsequent work should examine whether the treatment of depression can reduce excessive daytime sleepiness and improve sleep quality in DLB patients. Alternatively, more rigorous screening for sleep problems in DLB might assist the treatment of depression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Utilizing risk index for overdose or serious opioid-induced respiratory depression (RIOSORD) scores to prioritize offer of rescue naloxone in an outpatient veteran population: A telephone-based project.

Science.gov (United States)

Yates, Derek; Frey, Theresa; Montgomery, Jean Charles

2018-03-26

Since 2014, the Department of Veterans Affairs (VA) has been working to address the ongoing opioid epidemic through opioid-education initiatives, the development of risk calculators, and other risk stratification tools. One primary focus of VA efforts has been the distribution of rescue naloxone kits to veterans at greatest risk of opioid-related adverse events. The purpose of this project was to identify primary care veterans at highest risk for serious opioid-related adverse events using the Risk Index for Overdose and Serious Opioid-Induced Respiratory Depression (RIOSORD) and offer rescue naloxone kits by telephone-based outreach. RIOSORD is a risk-stratification tool developed and validated within the veteran population. Veterans identified at highest risk of overdose or opioid-related adverse effects were contacted by telephone or letter to offer to provide a rescue naloxone kit between November 1 st , 2016 and February 1 st , 2017. The primary outcome of the project was the percentage of patients contacted that agreed to a naloxone prescription. Secondary outcomes included comparative efficacy of phone versus letter contact and reasons for refusal of naloxone if the offer was declined. Of 41 veterans targeted by this project, most were successfully reached by telephone within three attempts (92.7%, n = 38). Approximately two-thirds of those reached by telephone agreed to a prescription for rescue naloxone (n = 26, 63.4%). The veterans that requested rescue naloxone selected the nasal formulation (n = 17) over the intramuscular auto-injector (n = 9). This project demonstrated that telephone-based outreach can be one method of distributing rescue naloxone to a high-risk patient population without requiring an in-person visit to a provider.

The portal of geriatrics online education: a 21st-century resource for teaching geriatrics.

Science.gov (United States)

Ramaswamy, Ravishankar; Leipzig, Rosanne M; Howe, Carol L; Sauvigne, Karen; Usiak, Craig; Soriano, Rainier P

2015-02-01

The way students are taught and evaluated is changing, with greater emphasis on flexible, individualized, learner-centered education, including the use of technology. The goal of assessment is also shifting from what students know to how they perform in practice settings. Developing educational materials for teaching in these ways is time-consuming and can be expensive. The Portal of Geriatrics Online Education (POGOe) was developed to aid educators in meeting these needs and become quicker, better-prepared teachers of geriatrics. POGOe contains more than 950 geriatrics educational materials that faculty at 45% of allopathic and 7% of osteopathic U.S. medical schools and the Centers for Geriatric Nursing Excellence have created. These materials include various instructional and assessment methodologies, including virtual and standardized patients, games, tutorials, case-based teaching, self-directed learning, and traditional lectures. Materials with common goals and resource types are available as selected educational series. Learner assessments comprise approximately 10% of the educational materials. POGOe also includes libraries of videos, images, and questions extracted from its educational materials to encourage educators to repurpose content components to create new resources and to align their teaching better with their learners' needs. Web-Geriatric Education Modules, a peer-reviewed online modular curriculum for medical students, is a prime example of this repurposing. The existence of a robust compendium of instructional and assessment materials allows educators to concentrate more on improving learner performance in practice and not simply on knowledge acquisition. It also makes it easier for nongeriatricians to teach the care of older adults in their respective disciplines. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Quality of life concerns and depression among hematopoietic stem cell transplant survivors.

Science.gov (United States)

Mosher, Catherine E; DuHamel, Katherine N; Rini, Christine; Corner, Geoffrey; Lam, Joanne; Redd, William H

2011-09-01

This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT). HSCT survivors (N=406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms. The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status. Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship.

Total Telephone Tips.

Science.gov (United States)

Corder, Lloyd E.; And Others

This manual of telephone behavior tips for business and sales professionals offers ways to handle the disgruntled caller and makes suggestions on topics relevant to the telephone. The manual is divided into the following sections and subsections: (1) Common Courtesy (staff tips, answering the telephone, screening calls, transferring calls, taking…

Geriatric fall-related injuries.

Science.gov (United States)

Hefny, Ashraf F; Abbas, Alaa K; Abu-Zidan, Fikri M

2016-06-01

Falls are the leading cause of geriatric injury. We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

Telephone Service

CERN Multimedia

2005-01-01

As part of the upgrade of telephone services, the CERN exchange switches will be updated on Thursday 2 June between 7.00 p.m. and midnight. Telephone services may be affected and possibly even disrupted during this operation. 

Demographic corrections for the modified Telephone Screening for Cognitive Status

OpenAIRE

Dennett, Kathryn; Tometich, Danielle; Duff, Kevin

2013-01-01

Despite the growing use of the modified Telephone Interview for Cognitive Status (mTICS) as a cognitive screening instrument, it does not yet have demographic corrections. Demographic data, mTICS, and a neuropsychological battery were collected from 274 community dwelling older adults with intact cognition or mild cognitive impairments. Age, education, premorbid intellect, and depression were correlated with mTICS scores. Using regression equations, age and education significantly predicted m...

Easing reintegration: telephone support groups for spouses of returning Iraq and Afghanistan service members.

Science.gov (United States)

Nichols, Linda Olivia; Martindale-Adams, Jennifer; Graney, Marshall J; Zuber, Jeffrey; Burns, Robert

2013-01-01

Spouses of returning Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) military service members report increased depression and anxiety post deployment as they work to reintegrate the family and service member. Reconnecting the family, renegotiating roles that have shifted, reestablishing communication patterns, and dealing with mental health concerns are all tasks that spouses must undertake as part of reintegration. We tested telephone support groups focusing on helping spouses with these basic reintegration tasks. Year-long telephone support groups focused on education, skills building (communication skills, problem solving training, cognitive behavioral techniques, stress management), and support. Spouse depression and anxiety were decreased and perceived social support was increased during the course of the study. In subgroup analyses, spouses with husbands whose injuries caused care difficulties had a positive response to the intervention. However, they were more likely to be depressed, be anxious, and have less social support compared to participants who had husbands who had no injury or whose injury did not cause care difficulty. Study findings suggest that this well-established, high-access intervention can help improve quality of life for military spouses who are struggling with reintegration of the service member and family.

International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

Science.gov (United States)

Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L.G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

2014-01-01

Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base. PMID:25071125

Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study.

Science.gov (United States)

Barger, Steven D; Messerli-Bürgy, Nadine; Barth, Jürgen

2014-03-24

The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N=12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p'sdepressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being.

Telephone Encounters Predict Future High Financial Expenditures in Inflammatory Bowel Disease Patients: A 3-Year Prospective Observational Study.

Science.gov (United States)

Click, Benjamin; Anderson, Alyce M; Ramos Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael A; Schwartz, Marc; Swoger, Jason; Barrie, Arthur; Szigethy, Eva; Regueiro, Miguel; Schoen, Robert E; Binion, David G

2018-04-01

Telephone activity is essential in management of complex chronic diseases including inflammatory bowel disease (IBD). Telephone encounters logged in the electronic medical record have recently been proposed as a surrogate marker of disease activity and impending health care utilization; however, the association between telephone calls and financial expenditures has not been evaluated. We performed a 3-year prospective observational study of telephone encounters logged at a tertiary referral IBD center. We analyzed patient demographics, disease characteristics, comorbidities, clinical activity, and health care financial charges by telephone encounter frequency. Eight hundred one patients met inclusion criteria (52.3% female; mean age, 44.1 y), accounted for 12,669 telephone encounters, and accrued $70,513,449 in charges over 3 years. High telephone encounter frequency was associated with female gender (P=0.003), anxiety/depression (Pfinancial charges the following year after controlling for demographic, utilization, and medication covariates. Increased telephone encounters are associated with significantly higher health care utilization and financial expenditures. Increased call frequency is predictive of future health care spending. Telephone encounters are a useful tool to identify patients at risk of clinical deterioration and large financial expense.

Do Geriatric Conditions Increase Risk of Adverse Drug Reactions in Ambulatory Elders? Results From the VA GEM Drug Study

Science.gov (United States)

Hanlon, Joseph T.; Sloane, Richard J.; Boscardin, W. John; Schmader, Kenneth E.

2011-01-01

Background. Many clinicians prescribe cautiously to older adults with common geriatric conditions for fear of causing adverse drug reactions (ADRs). However, little is known about the association between these conditions and risk of ADRs. Methods. Using data from the VA Geriatric Evaluation and Management Drug Study, we determined any, preventable, and serious ADRs in 808 elders for 12 months after hospital discharge using a validated process involving patient self-report and chart review adjudicated by two health care professionals. Eight common geriatric conditions (activities of daily living, dementia, incontinence, falls, difficulty ambulating, malnourishment, depression, and prolonged bed rest) were evaluated at study baseline through self-report and structured assessments. We used Poisson regression to model the relationship between these geriatric conditions and ADRs. Results. Participants had a mean of 2.9 ± 1.2 geriatric conditions. Over the 12-month follow-up period, 497 ADRs occurred in 269 participants, including 187 ADRs considered preventable and 127 considered severe. On multivariable analyses, participants with dependency in one or more activities of daily living were less likely to suffer ADRs than those who were fully independent (incidence rate ratio: 0.78, 95% confidence interval = 0.62–1.00). None of the other seven geriatric conditions assessed were associated with ADR risk. Results were similar for preventable and serious ADRs, although participants with a history of falls were more likely to develop serious ADRs (incidence rate ratio: 1.49, 95% confidence interval = 1.00–2.21). Conclusions. Many geriatric conditions were not associated with risk of ADRs. Although it is prudent to prescribe judiciously in patients with these conditions, excessive caution may not be warranted. PMID:21321003

[Non-pharmaceutical therapy of candidates for geriatric rehabilitation: Non-pharmaceutical therapy prescribed by SHI-accredited doctors after application for outpatient geriatric rehabilitative care].

Science.gov (United States)

Krupp, Sonja; Schnoor, Maike; Lohse, Kristina; Katalinic, Alexander; Willkomm, Martin

2015-06-01

The rejection of an application for ambulant geriatric rehabilitation (AGRV) is usually justified by the argument that non-pharmaceutical therapy prescribed by doctors accredited by social housing institutions (SHI) would suffice. The reality in healthcare during the 6 months following an application is unknown. In this study 203 patients who had made an application for AGRV in the second half of 2010 in Flensburg, Lübeck or Ratzeburg were interviewed by telephone. The survey revealed that 25.7% of the applications for AGRV had been rejected. The majority of these patients received no ambulant non-pharmaceutical therapy (e.g. physical therapy, physiotherapy, occupational therapy, speech therapy or psychological therapy), less than 20% received more than 12 therapy sessions and in most cases exclusively physiotherapy. The 141 successful AGRV applicants received additional ambulant therapies of a similar magnitude. The difference between the intensified interdisciplinary therapy offered in the AGRV and additionally and the offer to rejected applicants is substantial.

Prevention of late-life Depression in Primary Care: Do we know where to begin?

NARCIS (Netherlands)

Schoevers, R.; Smit, H.F.E.; Deeg, D.J.H.; Cuijpers, P.; Dekker, J.J.M.; van Tilburg, W.; Beekman, A.J.

2006-01-01

OBJECTIVE: This study attempted to compare two models for selective (people at elevated risk) and indicated (those with subsyndromal depressive symptoms) prevention and to determine the optimal strategy for prevention of late-life depression. METHOD: Onset was assessed at 3 years with the Geriatric

Speech perception and communication ability over the telephone by Mandarin-speaking children with cochlear implants.

Science.gov (United States)

Wu, Che-Ming; Liu, Tien-Chen; Wang, Nan-Mai; Chao, Wei-Chieh

2013-08-01

(1) To understand speech perception and communication ability through real telephone calls by Mandarin-speaking children with cochlear implants and compare them to live-voice perception, (2) to report the general condition of telephone use of this population, and (3) to investigate the factors that correlate with telephone speech perception performance. Fifty-six children with over 4 years of implant use (aged 6.8-13.6 years, mean duration 8.0 years) took three speech perception tests administered using telephone and live voice to examine sentence, monosyllabic-word and Mandarin tone perception. The children also filled out a questionnaire survey investigating everyday telephone use. Wilcoxon signed-rank test was used to compare the scores between live-voice and telephone tests, and Pearson's test to examine the correlation between them. The mean scores were 86.4%, 69.8% and 70.5% respectively for sentence, word and tone recognition over the telephone. The corresponding live-voice mean scores were 94.3%, 84.0% and 70.8%. Wilcoxon signed-rank test showed the sentence and word scores were significantly different between telephone and live voice test, while the tone recognition scores were not, indicating tone perception was less worsened by telephone transmission than words and sentences. Spearman's test showed that chronological age and duration of implant use were weakly correlated with the perception test scores. The questionnaire survey showed 78% of the children could initiate phone calls and 59% could use the telephone 2 years after implantation. Implanted children are potentially capable of using the telephone 2 years after implantation, and communication ability over the telephone becomes satisfactory 4 years after implantation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Telephoning in English

CERN Document Server

Naterop, B Jean

1994-01-01

Many people have to use English on the telephone in the course of their work, either at the level of taking a simple message or involving more complex tasks such as requesting information. Telephoning in English provides an up-to-date and relevant context in which students from lower-intermediate level upwards can develop practical telephone skills. The course principally develops spoken interactive skills, but also includes reading material on telephone systems and techniques. As the material is not restricted to particular job functions, it is suitable for students in a wide range of business and administration fields.

Identifying Dementia And Depression In The Elderly: The Role Of ...

African Journals Online (AJOL)

66 dementia package. The Geriatric Depression Scale (GDS), Family Questionnaire (FQ) and the Functional Activities Questionnaire (FAQ) were used to interview the family members of the patients. These were then compared with cognitively ...

Impact of in-home behavioral management versus telephone support to reduce depressive symptoms and perceived stress in Chinese caregivers: results of a pilot study.

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Gallagher-Thompson, Dolores; Gray, Heather L; Tang, Paulette C Y; Pu, Chun Yu; Leung, Laurie Y L; Wang, Peng-Chih; Tse, Collins; Hsu, Shannon; Kwo, Elizabeth; Tong, Hui-Qi; Long, James; Thompson, Larry W

2007-05-01

Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs). Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms. CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments. This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.

Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study

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2014-01-01

Background The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. Methods We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N = 12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. Results Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p’s social relationship domains except marital status were independently associated with depressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. Conclusions Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being. PMID:24656048

Building Psychosocial Programming in Geriatrics Fellowships: A Consortium Model

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Adelman, Ronald D.; Ansell, Pamela; Breckman, Risa; Snow, Caitlin E.; Ehrlich, Amy R.; Greene, Michele G.; Greenberg, Debra F.; Raik, Barrie L.; Raymond, Joshua J.; Clabby, John F.; Fields, Suzanne D.; Breznay, Jennifer B.

2011-01-01

Geriatric psychosocial problems are prevalent and significantly affect the physical health and overall well-being of older adults. Geriatrics fellows require psychosocial education, and yet to date, geriatrics fellowship programs have not developed a comprehensive geriatric psychosocial curriculum. Fellowship programs in the New York tristate area…

Socioeconomic status and survival among older adults with dementia and depression.

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Chen, Ruoling; Hu, Zhi; Wei, Li; Wilson, Kenneth

2014-06-01

People from lower socioeconomic groups have a higher risk of mortality. The impact of low socioeconomic status on survival among older adults with dementia and depression remains unclear. To investigate the association between socioeconomic status and mortality in people with dementia and late-life depression in China. Using Geriatric Mental Status - Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) we interviewed 2978 people aged ⩾60 years in Anhui, China. We characterised baseline socioeconomic status and risk factors and diagnosed 223 people with dementia and 128 with depression. All-cause mortality was followed up over 5.6 years. Individuals with dementia living in rural areas had a three times greater risk of mortality (multivariate adjusted hazard ratio (HR) = 2.96, 95% CI 1.45-6.04) than those in urban areas, and for those with depression the HR was 4.15 (95% CI 1.59-10.83). There were similar mortality rates when comparing people with dementia with low v. high levels of education, occupation and income, but individuals with depression with low v. high levels had non-significant increases in mortality of 11%, 50% and 55% respectively Older adults with dementia and depression living in rural China had a significantly higher risk of mortality than urban counterparts. Interventions should be implemented in rural areas to tackle survival inequality in dementia and depression. Royal College of Psychiatrists.

PALLIATIVE CARE IN GERIATRICS: CURRENT ISSUES AND PROSPECTS

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I. P. Рonomareva

2016-01-01

Full Text Available The purpose of the study is to identify the main problems and prospects of development of palliative care in geriatrics at the present stage. Method of research was to analyze the printed and electronic databases that meet the stated issues. The results of the study highlight the problems of the development of palliative care in geriatric practice: the lack of a developed procedure of rendering palliative care and adequate elderly patient selection criteria, the lack of trained professional staff. The main prospects-association of palliative practices and concepts of modern geriatrics required specialized geriatric assessment and the provision of clinical, medical, social and socio-psychological geriatric syndromes. While promising option for the development of palliative care geriatrics is the integration into the existing health care system, acceptance of the fact that it is a part of the specialized geriatric care. This requires the involvement and training of not only specialists with medical education, but also persons without medical training from among social workers and volunteers working in palliative care. Therefore, the obtained data allowed to conclude that topical is the development of palliative care in geriatrics, taking into account not only clinical but medico-social, socio-psychological features.

The Relationship between Locomotive Syndrome and Depression in Community-Dwelling Elderly People

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Misa Nakamura

2017-01-01

Full Text Available Locomotive syndrome (LS is a concept that refers to the condition of people requiring healthcare services because of problems associated with locomotion. Depression is a major psychiatric disease among the elderly, in addition to dementia. The purpose of this study was to determine the association between LS and depression. The study participants were 224 healthy elderly volunteers living in a rural area in Japan. LS was defined as scores ≥ 16 on the 25-question Geriatric Locomotive Function Scale (GLFS-25. Depression was defined as scores ≥ 5 on the 15-item Geriatric Depression Scale (GDS-15. Height and body weight were measured. The prevalence of LS and depression was 13.9% and 24.2%, respectively. Compared with the non-LS group, the LS group was older, was shorter, had a higher BMI, and had higher GDS-15 scores. Logistic regression analysis showed that participants with GDS-15 scores ≥ 6 had higher odds for LS than those with GDS-15 scores < 6 (odds ratio [OR] = 4.22. Conversely, the depression group had higher GLFS-25 scores than the nondepression group. Participants with GLFS-25 scores ≥ 5 had higher odds for depression than those with GLFS-25 scores < 5 (OR = 4.53. These findings suggest that there is a close relationship between LS and depression.

An assessesment of telephone assistance systems for caregivers of patients with Alzheimer's disease.

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Garzón-Maldonado, F J; Gutiérrez-Bedmar, M; Serrano-Castro, V; Requena-Toro, M V; Padilla-Romero, L; García-Casares, N

Telephone assistance is a common practice in neurology, although there are only a few studies about this type of healthcare. We have evaluated a Telephone Assistance System (TAS) for caregivers of patients with Alzheimer's disease (AD) from 2 points of view: financially and according to the level of satisfaction of the caregiver. 97 patients with a diagnosis of AD according to NINCDS-ADRDA criteria and their 97 informal caregivers were selected. We studied cost differences between on-site assistance and telephone assistance (TAS) for 12 months. We used a self-administered questionnaire to assess the level of satisfaction of caregivers at the end of the study period. TAS savings amounted to 80.05 ± 27.07 euros per user. 73.6% of the caregivers consider TAS a better or much better system than on-site assistance, while only 2.6% of the caregivers considered TAS a worse or much worse system than on-site assistance. Telephone assistance systems are an efficient healthcare resource for monitoring patients with AD in neurology departments. Furthermore, the level of user satisfaction was high. We therefore consider that telephone assistance service should be offered by healthcare services. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

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Jennifer C. Reneker; Kyra Weems; Vincent Scaia

2016-01-01

This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at th...

Prevalence and determinants for malnutrition in geriatric outpatients

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van Bokhorst-de van der Schueren, M.A.E.; Lonterman-Monasch, S.; de Vries, O.J.; Danner, S.A.; Kramer, M.H.H.; Muller, M.

2013-01-01

Background & aims: Few data is available on the nutritional status of geriatric outpatients. The aim of this study is to describe the nutritional status and its clinical correlates of independently living geriatric older individuals visiting a geriatric outpatient department. Methods: From 2005 to

Health policy 2016: implications for geriatric urology.

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Suskind, Anne M; Clemens, J Quentin

2016-03-01

The US healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore, will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. The Affordable Care Act has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination and risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues.

Evaluation of geriatric changes in dogs

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Soumyaranjan Pati

2015-03-01

Full Text Available Aim: The present study has been envisaged to ascertain the old age for critical management of geriatric dogs considering the parameters of externally visible changes, haemato-biochemical alterations and urine analysis in geriatric dogs approaching senility. Materials and Methods: The study was undertaken in the Department of Veterinary Pathology in collaboration with Teaching Veterinary Clinic complex spanning a period of 1 year. For screening of geriatric dogs, standard geriatric age chart of different breeds was followed. The external characteristics such as hair coat texture, dental wear and tear, skin texture and glaucoma were taken as a marker of old age. Haematology, serum biochemistry and urine analysis were also included in the study. Results: External visible changes like greying of hair, dull appearance of hair coat, glaucoma, osteoarthritis, dental wear and tear were commonly encountered in the aged dogs. The haemoglobin, total erythrocyte count and packed cell volume showed a decreasing trend in the geriatric groups. Biochemical values like total protein, albumin, calcium level showed a decreasing trend while urea level with an increasing trend in geriatric dogs without any much alteration in serum glutamicoxaloacetic transaminse, serum glutamic-pyruvate transaminase, cholesterol and creatinine. Physical examination of urine revealed yellow, amber, red, deep red color with turbidity and higher specific gravity. Chemical examination revealed presence of protein, glucose, ketone bodies, blood and bilirubin on some cases. The culture and sensitivity test of the urine samples revealed presence of bacteria with sensitive and resistance to some antibiotics. Conclusion: External visible changes are still the golden standard of determining the old age in dogs. Haemato-biochemical evaluation can be useful for correlating with the pathophysiological status of the animal. Biochemical analysis of urine can be employed rightly as kidney

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.

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Llewellyn-Jones, R H; Baikie, K A; Smithers, H; Cohen, J; Snowdon, J; Tennant, C C

1999-09-11

To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Population of residential facility in Sydney living in self care units and hostels. 220 depressed residents aged >/=65 without severe cognitive impairment. The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Geriatric depression scale. Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents.

Acute and long-term treatment of late-life major depressive disorder: duloxetine versus placebo.

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Robinson, Michael; Oakes, Tina Myers; Raskin, Joel; Liu, Peng; Shoemaker, Scarlett; Nelson, J Craig

2014-01-01

To compare the efficacy of duloxetine with placebo on depression in elderly patients with major depressive disorder. Multicenter, 24-week (12-week short-term and 12-week continuation), randomized, placebo-controlled, double-blind trial. United States, France, Mexico, Puerto Rico. Age 65 years or more with major depressive disorder diagnosis (one or more previous episode); Mini-Mental State Examination score ≥20; Montgomery-Asberg Depression Rating Scale total score ≥20. Duloxetine 60 or 120 mg/day or placebo; placebo rescue possible. Primary-Maier subscale of the 17-item Hamilton Depression Rating Scale (HAMD-17) at week 12. Secondary-Geriatric Depression Scale, HAMD-17 total score, cognitive measures, Brief Pain Inventory (BPI), Numeric Rating Scales (NRS) for pain, Clinical Global Impression-Severity scale, Patient Global Impression of Improvement in acute phase and acute plus continuation phase of treatment. Compared with placebo, duloxetine did not show significantly greater improvement from baseline on Maier subscale at 12 weeks, but did show significantly greater improvement at weeks 4, 8, 16, and 20. Similar patterns for Geriatric Depression Scale and Clinical Global Impression-Severity scale emerged, with significance also seen at week 24. There was a significant treatment effect for all BPI items and 4 of 6 NRS pain measures in the acute phase, most BPI items and half of the NRS measures in the continuation phase. More duloxetine-treated patients completed the study (63% versus 55%). A significantly higher percentage of duloxetine-treated patients versus placebo discontinued due to adverse event (15.3% versus 5.8%). Although the antidepressant efficacy of duloxetine was not confirmed by the primary outcome, several secondary measures at multiple time points suggested efficacy. Duloxetine had significant and meaningful beneficial effects on pain. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

Depression in elderly people living in rural Nigeria and its association with perceived health, poverty, and social network.

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Baiyewu, Olusegun; Yusuf, Abdulkareem Jika; Ogundele, Adefolakemi

2015-12-01

The relationship between late-life depression, poverty, social network, and perceived health is little studied in Africa; the magnitude of the problem remains largely unknown and there is an urgent need to research into this area. We interviewed community dwelling elderly persons of two rural areas in Nigeria using Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-30). Those who scored 11 and above on the GDS-30 were further interviewed using Geriatric Mental State Schedule (GMSS). Diagnosis of depression was based on the International Classification of Diseases 10th edition (ICD-10) and GMSS-Automated Geriatric Examination for Computer Assisted Taxonomy (GMMS-AGECAT). A total of 458 community dwelling elderly persons participated in the study of which 57% were females. Mean age of the participants was 73.65(±7.8) years (95% CI 72.93-74.37). The mean GDS-30 and MMSE scores were 4.15(±4.80) and 21.73(±4.67), respectively. A total of 59 and 58 participants had depression based on ICD-10 criteria and GMSS-AGECAT, respectively. Agreement between ICD-10 and AGECAT diagnoses was κ = 0.931. By multiple logistic regression analysis, late-life depression was significantly associated with financial difficulties (Odds ratio 4.52 and bereavement Odds ratio 2.70). Late-life depression in this cohort is associated with health and socio-economic factors that are worth paying attention to, in a region of economic deprivation and inadequate healthcare.

MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

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Cokorda Istri Devi Larayanthi

2013-04-01

Full Text Available Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, general medical conditions, medications, certain substances, and others. Management of insomnia in geriatric patients were divided into 3 method: 1 manage underlying cause, 2 nonpharmacological therapies such as cognitive behavior therapy (CBT, and 3 pharmacological therapies such as benzodiazepine and non-benzodiazepine that eszopiclone and Ramelteon. Pharmacological treatment in geriatrics should follow the rule "start low, go slow", starting dose of ½ of the adult dose, and its use in the short term.

Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly

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Blum, Manuel R; Wijsman, Liselotte W; Virgini, Vanessa S

2016-01-01

adults aged 70-82 years with pre-existing cardiovascular disease or known cardiovascular risk factors, TSH and free T4 levels were measured at baseline and repeated after 6 months to define persistent thyroid function status. Main outcome measures were depressive symptoms, assessed with the Geriatric...... on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which......BACKGROUND: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. METHODS: In the Leiden sub-study of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) among...

[Mini-Mental State Examination in geriatrics : An evaluation of diagnostic quality].

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Beyermann, S; Trippe, R H; Bähr, A A; Püllen, R

2013-12-01

Several studies have identified moderate reliability and validity for the Mini-Mental State Examination (MMSE). Some researchers showed the superiority of other dementia screening tests over the MMSE considering the test quality criteria. The aim of this study was the evaluation of MMSE, especially in the area of geriatrics. MMSE and DemTect were carried out with 154 geriatric patients: 71 persons without cognitive impairment and 83 persons without delirium showed cognitive impairments as revealed by the DemTect. In addition, we also applied the Clock-Drawing-Test (CDT), Reisberg-Scale, Geriatric Depression-Scale (GDS, 15-item version) and the Confusion-Assessment-Method (CAM). According to the multitrait-multimethod approach, MMSE's convergent and divergent validity is similar to that of the DemTect. Both tests correlate only moderately with Spearman (r = 0.609) and revealed similar results for dementia in 57.1 % of the patients. MMSE showed low reliability and moderate reliability (Cronbach's α = 0.82) when ten items with low discriminatory power were excluded from the total test score. Difficulty of all items is only moderate (p = 0.86) and only eight items of the MMSE showed good test difficulty. All in all, DemTect and MMSE are not interchangeable. The MMSE estimates the average cognitive impairment of patients as considerably less pronounced than the DemTect. MMSE is, thus, not an instrument that would be recommended for the identification of mild cognitive impairment. In this case, tests with higher reliability and validity should be used.

Validez y confiabilidad del cuestionario del ENASEM para la depresión en adultos mayores Validity and reliability of the screening questionnaire for geriatric depression used in the Mexican Health and Age Study

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Sara Gloria Aguilar-Navarro

2007-08-01

Full Text Available OBJETIVO: Estimar la validez y confiabilidad de un instrumento para detectar depresión en adultos mayores. MATERIAL Y MÉTODOS: El estudio se realizó en la consulta externa del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ, entre mayo de 2005 y marzo de 2006. Se utilizaron el diagnóstico clínico de depresión a través de el Manual Diagnóstico y Estadístico de Trastornos Mentales, en su cuarta versión revisada (DSM-IV-TR, y la Escala de depresión geriátrica (EDG de Yesavage, para establecer las propiedades clinimétricas de un cuestionario dicotómico de nueve reactivos, desprendido del Estudio Nacional sobre Salud y Envejecimiento en México (ENASEM. RESULTADOS: En el proceso de validación participaron 199 individuos de edad media de 79.5 años. El resultado del cuestionario de la ENASEM estuvo significativamente correlacionado con el diagnóstico clínico de depresión (pOBJECTIVE: To assess the validity and reliability of a geriatric depression questionnaire used in the Mexican Health and Age Study (MHAS. METHODS: The study was conducted at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ clinic from May 2005 to March 2006. This depression screening nine-item questionnaire was validated using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR (fourth revised version and Yesavage's 15-item Geriatric Depression Scale (GDS-15 criteria. The instrument belongs to the MHAS, a prospective panel study of health and aging in Mexico. RESULTS: A total of 199 subjects 65 years of age and older participated in the validation process (median age= 79.5 years. MHAS questionnaire result was significantly correlated to the clinical depression diagnosis (p<0.001 and to the GDS-15 score (p<0.001. Internal consistency was adequate (alpha coefficient: 0.74. The cutoff point e" 5/9 points yielded an 80.7% and 68.7% sensitivity and specificity respectively. The fidelity

Analysis and Management of Geriatric Anxiety.

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Sallis, James F.; Lichstein, Kenneth L.

1982-01-01

Reviews the prevalence, negative health implications, and clinical management of geriatric anxiety. Proposes an interactive model of geriatric anxiety whereby physical disease and anxiety processes enter into reciprocal stimulation as a function of diminished capacity to withstand stress and hypervigilance of stress symptomatology. Outlines…

Pain grade and sleep disturbance in older adults: evaluation the role of pain, and stress for depressed and non-depressed individuals.

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Eslami, Vahid; Zimmerman, Molly E; Grewal, Trishdeep; Katz, Mindy; Lipton, Richard B

2016-05-01

The aim of this paper was to assess the relationship between pain and sleep in older adults taking depression, stress, and medical comorbidities into account. A cross-sectional analysis was performed using Einstein Aging Study, a community-based cohort study of adults aged 70 years and older. Ratings of pain intensity and interference from the Medical Outcomes Study (MOS) Short-Form 36 were used to assign individuals to low-pain versus high-pain severity. Sleep disturbance was assessed using the nine-item sleep problems index from the Medical Outcomes Study Sleep Scale. Other measures included the Geriatric Depression Scale and Perceived Stress Scale (PSS). Linear regression models were used to assess the association between pain grade and sleep disturbance adjusted for demographics, PSS, Geriatric Depression Scale, and other comorbidities. Five hundred sixty-two eligible participants with a mean age of 78.22 years (standard deviation = 5.43) were included; 64% were women. Pain grade [β = 5.40, 95% confidence interval (CI) 2.56-8.21, p pain grade (β = 3.08, 95% CI 0.32-5.85, p = 0.03) and PSS (β = 0.57, 95% CI 0.39-0.75, p pain and sleep by 34%. Depression, when added to previous model, was also associated with sleep (β = 2.17, 95% CI 1.48-2.85, p pain (β = 2.41, 95% CI -0.25 to 5.08, p = 0.07) and sleep by 22%. Stratified for depression, we found that pain, stress, and other medical comorbidities were significantly associated with sleep disturbance in non-depressed individuals but not individuals with depression. Pain, stress, and medical comorbidities are associated with sleep disturbance, especially in non-depressed older adults. Copyright © 2015 John Wiley & Sons, Ltd.

WATER AND SALT METABOLISM IN THE GERIATRIC SYNDROMES

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Carlos G. Musso

2010-01-01

Full Text Available Geriatrics has already described four syndromes of its own: confusional syndrome, incontinence (fecal and/or urinary, and gait disorders and immobility syndrome, naming them geriatric giants. This name reflects their prevalence and great importance in the elderly. Ageing process induces many changes in renal physiology such as a reduction in glomerular filtration rate (senile hyponatremia, and water and sodium reabsorbtion capability. Besides, there are particular water and salt metabolism alteration characteristics of the geriatric syndromes, such as dehydration and hypernatremia in psychiatric disturbances as well as hyponatremia in patients suffering from immobility syndrome. The geriatric giants and nephrogeriatric physiology changes, are a good example of feed-back between geriatric syndromes, clinical entities characteristics in the elderly that predispose and potentiate each other, leading to catastrophic clinical events.

Effects of inpatient geriatric interventions in a German geriatric hospital: Impact on ADL, mobility and cognitive status.

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Bordne, S; Schulz, R-J; Zank, S

2015-06-01

Given the demographic changes, the need for effective geriatric intervention is obvious. Geriatric care aims to maintain the highest possible level of independence and quality of life and to reduce the risk of need for care. This study investigated the benefits of geriatric care on functional performance, mobility and cognition. This study involved a retrospective analysis of clinical data from 646 patients. At hospital admission and discharge functional status was assessed using the Barthel index. Mobility was evaluated by means of the Tinetti test and cognition by the mini-mental state examination (MMSE). A follow-up was conducted on 112 patients 2-5 months after hospital discharge. Statistical analysis included t-tests including Cohen's d for effect size and multivariate regression analysis. The mean age of the study population was 81.1 ± 7.1 years including 439 women (68%) and 207 men (32%). There were significant average improvements for activities of daily living (ADL), mobility and cognition comparing discharge and admission scores. For functional and mobility status, effect sizes were medium to high. Regression analyses showed that ADL improvement was predicted by functional, mobile and cognitive status at admission. Follow-up analyses revealed a high percentage of former patients still living at home and an overall maintenance of ADL levels. Geriatric patients seem to experience long-term improvements during geriatric treatment, which appears to fulfill its aim of recovering independence. For a better understanding of relevant factors for the recreation of geriatric patients, further research is needed, e.g. with respect to the impact of the nutritional status.

The Magnitude of Atherogenic Dyslipidaemia among Geriatric ...

African Journals Online (AJOL)

The Magnitude of Atherogenic Dyslipidaemia among Geriatric Nigerians with ... June 2011 on 122 consecutive geriatric patients with systemic hypertension ... of dyslipidaemia and a marker of dyslipidaemic cardiometabolic risk among them.

Public beliefs and attitudes towards depression in Italy: a national survey.

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Carmine Munizza

Full Text Available BACKGROUND: Previous studies have shown that attitudes towards depression may be influenced by country-specific social and cultural factors. A survey was carried out to collect beliefs on and attitudes toward depression in Italy, which has an established community-based mental health system. METHODS: A telephone survey was carried out in a probabilistic sample aged ≥15 years. A 20-item questionnaire was administered to explore knowledge of depression, stigma, causal beliefs, treatment preference, and help-seeking attitudes. RESULTS: Of the 1001 participants, 98% were aware of depression, and 62% had experienced it, either directly or indirectly. A widespread belief (75% was that people suffering from depression should avoid talking about their problem. A minority of the sample viewed depression as a condition that should be managed without recourse to external help or a "socially dangerous" illness. Among perceived causes of depression, most respondents mentioned life stressors or physical strains. Psychologists were often indicated as an adequate source of professional help. Half of the sample believed that depression should be pharmacologically treated, but drugs were often seen as addictive. Referring to a primary care physician (PCP was considered embarrassing; furthermore, many people thought that PCPs are too busy to treat patients suffering from depression. CONCLUSIONS: Our findings indicate that depression is seen as a reaction to significant life events that should be overcome with the support of significant others or the help of health professionals (mainly psychologists. However, there are still barriers to the disclosure of depressive symptoms to PCPs, and concerns about the addictive effect of antidepressants. In the presence of a gap between people's beliefs and what health professionals consider appropriate for the treatment of depression, a "shared decision making" approach to treatment selection should be adopted taking into

The effect of nurse-led problem-solving therapy on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease: a randomised controlled trial.

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Lee, Haejung; Yoon, Ju Young; Lim, Yeonjung; Jung, HeeYoung; Kim, Sungmin; Yoo, Younja; Kim, Yunseong; Ahn, Jong-Joon; Park, Hye-Kyung

2015-05-01

to examine the effects of nurse-led, problem-solving therapy (PST) on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease (COPD) using a randomised controlled trial. a total of 254 patients with COPD were recruited, screened and randomly allocated into the intervention group with nurse-led PST or the comparison group with usual care. A total of 151 patients (intervention = 78 and comparison = 73) completed the study for 6 months. the nurse-led PST was an individualised and patient-centred intervention to improve patients' problem-solving skills related to symptom management and lifestyle modification. Twelve telephone-based PST sessions were provided to the intervention group, while the control group received usual care from their primary care providers. there were no group differences of post-test scores in problem-oriented coping, self-efficacy and depressive symptoms between the two groups. However, despite the lack of group differences, the nurse-led PST was effective for clinically depressed patients with COPD, who experienced decreased depressive symptoms (mean difference = 6.8, P = 0.009) and increased self-efficacy (mean difference = -0.6, P = 0.041) in the intervention group (n = 12). the nurse-led PST offered to patients with COPD did not demonstrate any different effects compared with usual care over 6 months; however, a subgroup analysis with clinically depressed subjects showed improved self-efficacy and decreased depressive symptoms in the intervention group. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Endoprostheses in geriatric traumatology].

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Buecking, B; Eschbach, D; Bliemel, C; Knobe, M; Aigner, R; Ruchholtz, S

2017-01-01

Geriatric traumatology is increasing in importance due to the demographic transition. In cases of fractures close to large joints it is questionable whether primary joint replacement is advantageous compared to joint-preserving internal fixation. The aim of this study was to describe the importance of prosthetic joint replacement in the treatment of geriatric patients suffering from frequent periarticular fractures in comparison to osteosynthetic joint reconstruction and conservative methods. A selective search of the literature was carried out to identify studies and recommendations concerned with primary arthroplasty of fractures in the region of the various joints (hip, shoulder, elbow and knee). The importance of primary arthroplasty in geriatric traumatology differs greatly between the various joints. Implantation of a prosthesis has now become the gold standard for displaced fractures of the femoral neck. In addition, reverse shoulder arthroplasty has become an established alternative option to osteosynthesis in the treatment of complex proximal humeral fractures. Due to a lack of large studies definitive recommendations cannot yet be given for fractures around the elbow and the knee. Nowadays, joint replacement for these fractures is recommended only if reconstruction of the joint surface is not possible. The importance of primary joint replacement for geriatric fractures will probably increase in the future. Further studies with larger patient numbers must be conducted to achieve more confidence in decision making between joint replacement and internal fixation especially for shoulder, elbow and knee joints.

Late onset depression: A recent update

Directory of Open Access Journals (Sweden)

Ananya Mahapatra

2015-01-01

Full Text Available Late onset depression has recently emerged as a serious mental health issue in the geriatric population with significant public health implications. It is often challenging to diagnose and treat this entity. Various theories have been postulated to elucidate the etiology of late onset depression, but a unifying hypothesis is lacking. Although the vascular hypothesis is most researched; a complex interaction of multiple vulnerability factors is the current focus of attention. Numerous psychosocial variables have been implicated to play a significant role in predicting the onset and severity of late-life depression. Phenomenological differences have been delineated from depression occurring at a younger age, but the findings are equivocal. A better understanding of the natural trajectory of depression in the elderly is required for early diagnosis and effective treatment. This review attempts to summarize the current status of evidence regarding epidemiology, etiology, clinical features, and treatment options available for late-onset depression.

Geriatric and Student Perceptions following Student-led Educational Sessions

Directory of Open Access Journals (Sweden)

Kristin Janzen

2018-01-01

Full Text Available Objective: The objective of this study was to measure the effect of student-led educational events on geriatric patient and student participant perceptions in a community setting. Methods: Students led three events at a senior community center, focusing on learning and memory, sleep hygiene, and arthritis pain. The participants were geriatric patients who themselves were providers of support to homebound peers (“clients” through an independently organized program. Geriatric participants completed pre- and post-event surveys to measure changes in familiarity with the topics. Student participants also completed pre- and post-event surveys that tracked changes in their comfort in working with the geriatric population. Results: Each event demonstrated at least one positive finding for geriatric patients and/or their clients. Students reported increased comfort in working with and teaching the geriatric population following the first and third events, but not the second. Conclusion: Student-led educational sessions can improve perceived health-related knowledge of geriatric participants while simultaneously exposing students to the geriatric patient population. Overall, both students and geriatric participants benefited from these events. Practice Implications: Incorporation of single, student-led educational events could be mutually beneficial to students and the elderly population in the community and easily incorporated into any healthcare curriculum. Funding:This work was supported by a Butler University Innovation Fund Grant. Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

Sensitivity and Specificity Analysis: Use of Emoticon for Screening of Depression in Elderly in Singapore.

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Tan, Laurence; Toh, Hui Jin; Sim, Lai Kiow; Low, James Alvin

2018-03-01

The current screening tools for depression can be tedious to administer, especially in the elderly population with hearing impairment and/or limited proficiency in English language. To look at the feasibility of using emoticon as a screening and assessment tool for depression in the elderly. Cross-sectional study. A total of 77 elderly patients completed the study from June 2014 to August 2015 in a general geriatric outpatient clinic of an acute care hospital in Singapore. Patients rated their mood using an emoticon scale, which ranges from 1 ( most happy face) to 7 ( most sad face). Depression was assessed using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria as the gold standard. Sensitivity and specificity for depression were calculated for the cutoff scores from 1 to 7 on the emoticon scale. The sensitivity percentages were low across all cutoff scores. The specificity was more than 90% for the cutoff score of 5 and above on the emoticon scale. However, all the patients who had depression diagnosed using the DSM-IV criteria did not have emoticon scores of 5 and above. The emoticon scale was easy to use, but its effectiveness in the screening of depression in the elderly needs to be explored further. The inability to use the emoticon scale as a tool may be the lack of measurements in the other domains of the DSM-IV criteria (sleep, energy, appetite, etc.), rather than failure of the emoticon scale to assess mood.

Depressive Symptoms, Falls, and Fear of Falling in Old Korean Adults: The Korean Longitudinal Study on Health and Aging (KLoSHA).

Science.gov (United States)

Park, Y; Paik, N-J; Kim, K W; Jang, H-C; Lim, J-Y

2017-01-01

Fall is a common cause of disability and death in old adults, and much research has been focused on identifying risk factors and developing preventive measures. Yet the majority of preceding research has been focused on physical performance. This study aims to evaluate the association between fall and depressive symptoms in community-dwelling elderly. Cross-sectional data of 431 men and 546 women was collected from old Korean adults living in Seongnam, Korea. Geriatric fall assessment was conducted by self-report questionnaires. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. Results indicated that depressive symptoms were associated with both fall and fear of falling in old adults. A clear gender difference was newly discovered, as depression played a stronger role in women. These results imply that clinicians should consider the negative affect of geriatric patients when assessing fall risk. Also, measures against depression might be effective in reducing falls.

[Family functioning of elderly with depressive symptoms].

Science.gov (United States)

Souza, Rosely Almeida; Desani da Costa, Gislaine; Yamashita, Cintia Hitomi; Amendola, Fernanda; Gaspar, Jaqueline Correa; Alvarenga, Márcia Regina Martins; Faccenda, Odival; Oliveira, Maria Amélia de Campos

2014-06-01

To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.

Telephone based cognitive-behavioral screening for frontotemporal changes in patients with amyotrophic lateral sclerosis (ALS).

Science.gov (United States)

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R; Mitsumoto, Hiroshi

Our objective was to establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the telephone. Thirty-one subjects were administered either in-person or by telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Equivalence testing was performed for in-person and telephone based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level compared to a revised phone version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level, respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). In conclusion, our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone based cognitive testing for ALS could become an integral resource for population based research in the future.

Role of telephone triage in obstetrics.

Science.gov (United States)

Manning, Nirvana Afsordeh; Magann, Everett F; Rhoads, Sarah J; Ivey, Tesa L; Williams, Donna J

2012-12-01

The telephone has become an indispensable method of communication in the practice of obstetrics. The telephone is one of the primary methods by which the patient makes her appointments and contacts her health care provider for advice, reassurance, and referrals. Current methods of telephone triage include personal at the physicians' office, telephone answering services, labor and delivery nurses, and a dedicated telephone triage system using algorithms. Limitations of telephone triage include the inability of the provider to see the patient and receive visual clues from the interaction and the challenges of obtaining a complete history over the telephone. In addition, there are potential safety and legal issues with telephone triage. To date, there is insufficient evidence to either validate or refute the use of a dedicated telephone triage system compared with a traditional system using an answering service or nurses on labor and delivery. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to analyze the scope of variation in telephone triage across health care providers and categorize the components that go into a successful triage system, assess the current scope of research in telephone triage in obstetrics, evaluate potential safety and legal issues with telephone triage in obstetrics, and identify issues that should be addressed in any institution that is using or implementing a system of telephone triage in obstetrics.

Enhancing Geriatric Curriculum in Nursing School

Science.gov (United States)

Collins, Kevin

2013-01-01

People are living longer. The average age of the population is increasing, and is expected to keep growing. Any person age 65 and older is now considered "geriatric." However, although growing, this population is not receiving adequate nursing care, and results in increased pain, falls, and even death. Geriatric curriculum is becoming…

The geriatric polytrauma: Risk profile and prognostic factors.

Science.gov (United States)

Rupprecht, Holger; Heppner, Hans Jürgen; Wohlfart, Kristina; Türkoglu, Alp

2017-03-01

In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS). Age, hemoglobin (Hb) level, systolic blood pressure (BP), Glasgow Coma Scale (GCS) score, timing of and necessity for intubation were analyzed in relation to mortality and in comparison with younger patients. Geriatric polytrauma patients (n=140) had overall mortality rate of 65%, whereas younger patients (n=1468) had mortality rate of 15.9%. Despite equivalent severity of injury (HPTS less age points) in geriatric and non-geriatric groups, mortality rate was 4 times higher in geriatric group. Major blood loss with Hb polytrauma patients. Additional risk factors include very low GCS score and systolic BP <80 mm Hg, for instance, as potential clinical indicators of massive bleeding and traumatic brain injury. Such parameters demand early and rapid treatment at prehospital stage and on admission.

Do we need community geriatrics?

LENUS (Irish Health Repository)

O'Hanlon, S

2012-01-30

Community geriatrics has evolved as a specific aspect of geriatric medicine in the UK. In Ireland there is uncertainty as to how it should be planned. This is the first national survey of consultants, specialist registrars and general practitioners to seek their opinions. Most consultants and GPs reported already having a community aspect to their current practice, e.g. nursing home visits or community hospital visits, whereas most SpRs did not. Forty three of 62 respondents (69%) agreed that there is a need for community geriatricians and that there should be integration with hospital medicine. Fifty seven of 62 respondents (92%) felt that there would be a beneficial effect on GP services, though some expressed concern about work overlap. Thirteen of the 25 SpRs (52%) in training hoped to begin practice in community geriatrics in the future.

DEPRESSION IN PRIMARY CARE. PART 1: SCREENING AND DIAGNOSIS

Directory of Open Access Journals (Sweden)

XV Pereira

2007-01-01

Full Text Available One of the commonest psychological problems that a clinician would encounter in primary care is depression. Theprevalence of depression is high in women, the elderly and those with underlying physical problems or during the postpartumperiod. The spectrum of clinical presentations is wide and somatic complaints are more common in primary care clinics.Depression may present as a primary disorder and co-morbidity with other psychological problems or physical illnessesis high. A good clinical interview is an important form of assessment and a quick screening of depression can be donewith the administration of proper rating scales, such as the Patient Health Questionnaire, Hamilton Depression RatingScale or Geriatric Depression Scale. Repeated use of the same scale in a patient would help the clinician to monitor theprogress objectively.

Sex differences in depressive effects of experiencing spousal bereavement.

Science.gov (United States)

Lee, Hyo Jung; Lee, Sang Gyu; Chun, Sung-Youn; Park, Eun-Cheol

2017-02-01

Spousal death is a significant event that becomes a turning point in an individual's life. Widowed persons experience new circumstances, which might induce depression. However, the effects of spousal death on depression can differ by sex and culture. Thus, the present study examined the association between depressive levels and experience of spousal death in Korean adults aged older than 45 years. The data were from the Korean Longitudinal Study of Aging from 2010 to 2012. The analysis used frequency analysis to compare the distribution of demographic variables between men and women, and anova to compare 10-item short-form Center for Epidemiological Studies Depression Scale scores as the dependent variable among comparison groups. We also carried out linear mixed model analysis on the association between the 10-item short-form Center for Epidemiological Studies Depression Scale and experience of spousal death. Among 5481 respondents, 2735 were men and 2741 were women. The number of men and women who experienced spousal death were 43 (1.6%) and 181 (6.6%), respectively. Men had lower depressive levels than women when they had been married (men 2.99, women 3.64). Both men and women experiencing spousal death had significantly higher 10-item short-form Center for Epidemiological Studies Depression Scale scores than married men and women (men β = 0.911, P = 0.003; women β = 0.512, P = 0.001; ref: no experience of spousal death). There was a significant association between experience of spousal death and depressive level for both men and women. We suggest that policy practitioners promote community programs that provide bereaved adults with easy access to meaningful social participation and support the minimum cost of living of the widowed. Geriatr Gerontol Int 2017; 17: 322-329. © 2016 Japan Geriatrics Society.

Long-term incidence of depression and predictors of depressive symptoms in older stroke survivors.

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Allan, Louise M; Rowan, Elise N; Thomas, Alan J; Polvikoski, Tuomo M; O'Brien, John T; Kalaria, Raj N

2013-12-01

Depression is common and an important consequence of stroke but there is limited information on the longer-term relationship between these conditions. To identify the prevalence, incidence and predictors of depression in a secondary-care-based cohort of stroke survivors aged over 75 years, from 3 months to up to 10 years post-stroke. Depression was assessed annually by three methods: major depression by DSM-IV criteria, the self-rated Geriatric Depression Scale (GDS) and the observer-rated Cornell scale. We found the highest rates, 31.7% baseline prevalence, of depressive symptoms with the GDS compared with 9.7% using the Cornell scale and 1.2% using DSM-IV criteria. Incidence rates were 36.9, 5.90 and 4.18 episodes per 100 person years respectively. Baseline GDS score was the most consistent predictor of depressive symptoms at all time points in both univariate and multivariate analyses. Other predictors included cognitive impairment, impaired activities of daily living and in the early period, vascular risk factor burden and dementia. Our results emphasise the importance of psychiatric follow-up for those with early-onset post-stroke depression and long-term monitoring of mood in people who have had a stroke and remain at high risk of depression.

Biological therapy in geriatric patients

International Nuclear Information System (INIS)

Mego, M.

2012-01-01

Targeted biological therapy, alone or in combination with conventional chemotherapy, make significant progress in the treatment of patients with malignancy. Its use as opposed to high-dose chemotherapy is not limited by age, nevertheless, we have relatively little knowledge of the toxicity and effectiveness in geriatric patients. Aim of this article is to give an overview of the biological effectiveness and toxicity of anticancer therapy in geriatric patients, based on published data. (author)

Rapid psychological assessment of depression and its relationship with physical health among urban elderly

OpenAIRE

Pavithra Cheluvaraj; Mangesh Balu Nanaware; Surya Prakasa Rao

2016-01-01

Background Old age is associated with increased occurrence of a wide array of Psychological impairments or losses, which might contribute to physical disabilities. As Depression has been identified as the most common aberration its rapid assessment would be able to identify the quality of individual and family life of the elderly. Aims To assess psychological health status with respect to depression among geriatric urban community, and the relationship of depression with health perce...

Malignancies of gastrointestinal tract in geriatric patients

International Nuclear Information System (INIS)

Bystricky, B.

2017-01-01

Incidence of gastrointestinal cancer rises with age. In spite of this fact, older patients are underrepresented in clinical trials. We need to take into account several variables prior to selection of therapy in these patients. These are physiologic aging processes, comorbidities, functional and cognitive status. There are several assessment tools in geriatric population – the most used is comprehensive geriatric assessment (CGA). A close cooperation with geriatrician is useful before starting cancer treatment. This article reviews treatment algorithms in selected malignancies of GI tract in geriatric patients. (author)

Is the Effect of Postpartum Depression on Mother-Infant Bonding Universal?

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Badr, Lina Kurdahi; Ayvazian, Nelly; Lameh, Salma; Charafeddine, Lama

2018-05-01

Although the negative consequences of maternal depression on infants has been documented in several Western societies, similar studies have not been conducted in Middle-Eastern countries where cultural norms and traditions may differ. The main objective of this study was to determine the risk factors for postpartum depression (PPD) and its relationship to mother -infant bonding in a Lebanese population. One hundred and fifty participants were administered the Edinburgh Postpartum Depression Scale (EPDS), and the social support scale at 2-3 days postpartum. At 10-12 weeks mother-infant bonding using the Postpartum Bonding Questionnaire (PBQ) and depression using the Beck Inventory (BDI-II) were assessed during a telephone interview. The prevalence of depression was 19% with an average score of 10.9 ± 6.02 on the EPDS. At 10-12 weeks 2.7% of the whole sample was depressed with an average score of 18.60 ± 16.87 on the BDI-II. Risk factors of PPD on the EPDS were; history of alcohol use, complications during pregnancy, not a good marital relationship, baby admitted to an intensive care unit, history of depression and low social support. Risk factors for impaired bonding were age, history of depression, BDI-II scores above 20 and low social support. The multiple regression analysis found that impaired bonding was associated with older age, history of depression and low social support, which explained 39% of the variance, F = 7.12, p = 0.02. The prevalence of PPD was higher than previously reported at day 2-3 post-delivery, but lower at 10-12 weeks postpartum. Impaired mother- infant bonding was associated older mothers, history of depression, low social support and BDI-II scores above 20 which should alert practitioner to assessing these factors in post-partum mothers. Copyright © 2018. Published by Elsevier Inc.

Short assessment of the Big Five: robust across survey methods except telephone interviewing.

Science.gov (United States)

Lang, Frieder R; John, Dennis; Lüdtke, Oliver; Schupp, Jürgen; Wagner, Gert G

2011-06-01

We examined measurement invariance and age-related robustness of a short 15-item Big Five Inventory (BFI-S) of personality dimensions, which is well suited for applications in large-scale multidisciplinary surveys. The BFI-S was assessed in three different interviewing conditions: computer-assisted or paper-assisted face-to-face interviewing, computer-assisted telephone interviewing, and a self-administered questionnaire. Randomized probability samples from a large-scale German panel survey and a related probability telephone study were used in order to test method effects on self-report measures of personality characteristics across early, middle, and late adulthood. Exploratory structural equation modeling was used in order to test for measurement invariance of the five-factor model of personality trait domains across different assessment methods. For the short inventory, findings suggest strong robustness of self-report measures of personality dimensions among young and middle-aged adults. In old age, telephone interviewing was associated with greater distortions in reliable personality assessment. It is concluded that the greater mental workload of telephone interviewing limits the reliability of self-report personality assessment. Face-to-face surveys and self-administrated questionnaire completion are clearly better suited than phone surveys when personality traits in age-heterogeneous samples are assessed.

The social network index and its relation to later-life depression among the elderly aged ≥80 years in Northern Thailand

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Aung MN

2016-08-01

Full Text Available Myo Nyein Aung,1 Saiyud Moolphate,2 Thin Nyein Nyein Aung,3 Chitima Katonyoo,2 Songyos Khamchai,4 Pongsak Wannakrairot1 1Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Public Health, Chiang Mai Rajabhat University, Chiang Mai, Thailand; 3Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan; 4Chiang Mai Provincial Health Office, Chiang Mai, Thailand Background: Having a diverse social network is considered to be beneficial to a person’s well-being. The significance, however, of social network diversity in the geriatric assessment of people aged ≥80 years has not been adequately investigated within the Southeast Asian context. This study explored the social networks belonging to the elderly aged ≥80 years and assessed the relation of social network and geriatric depression. Methods: This study was a community-based cross-sectional survey conducted in Chiang Mai Province, Northern Thailand. A representative sample of 435 community residents, aged ≥80 years, were included in a multistage sample. The participants’ social network diversity was assessed by applying Cohen’s social network index (SNI. The geriatric depression scale and activities of daily living measures were carried out during home visits. Descriptive analyses revealed the distribution of SNI, while the relationship between the SNI and the geriatric depression scale was examined by ordinal logistic regression models controlling possible covariants such as age, sex, and educational attainment. Results: The median age of the sample was 83 years, with females comprising of 54.94% of the sample. The participants’ children, their neighbors, and members of Buddhist temples were reported as the most frequent contacts of the study participants. Among the 435 participants, 25% were at risk of social isolation due to having a “limited” social network group (SNI 0–3, whereas 37% had a “medium” social network

Psychotherapeutic intervention by telephone

Directory of Open Access Journals (Sweden)

Erika Mozer

2008-06-01

Full Text Available Erika Mozer1,2, Bethany Franklin1,3, Jon Rose11Department of Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA, USA; 2PGSP Stanford PsyD Consortium Palo Alto, CA, USA; 3Pacific Graduate School of Psychology Palo Alto, California, USAAbstract: Psychotherapy conducted over the telephone has received increasing amounts of empirical attention given practical advantages that side-step treatment barriers encountered in traditional office-based care. The utility and efficacy of telephone therapy appears generalizable across diverse clinical populations seeking care in community-based hospital settings. Treatment barriers common to older adults suggest that telephone therapy may be an efficient and effective mental health resource for this population. This paper describes empirical studies of telehealth interventions and case examples with psychotherapy conducted via telephone on the Spinal Cord Injury Unit of the Palo Alto Veterans’ Administration. Telephone therapy as appears to be a viable intervention with the aging population.Keywords: telehealth, rural mental health, psychotherapy, healthcare delivery, telecare

Health Policy 2016 – Implications for Geriatric Urology

Science.gov (United States)

Suskind, Anne M.; Clemens, J. Quentin

2016-01-01

Purpose of Review The U.S. healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. Recent Findings The Affordable Care Act (ACA) has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Summary Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination, risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues. PMID:26765043

Family functioning of elderly with depressive symptoms

Directory of Open Access Journals (Sweden)

Rosely Almeida Souza

2014-06-01

Full Text Available Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms. The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.

Impact of depression on health care utilization and costs among multimorbid patients--from the MultiCare Cohort Study.

Directory of Open Access Journals (Sweden)

Jens-Oliver Bock

Full Text Available OBJECTIVE: The objective of this study was to describe and analyze the effects of depression on health care utilization and costs in a sample of multimorbid elderly patients. METHOD: This cross-sectional analysis used data of a prospective cohort study, consisting of 1,050 randomly selected multimorbid primary care patients aged 65 to 85 years. Depression was defined as a score of six points or more on the Geriatric Depression Scale (GDS-15. Subjects passed a geriatric assessment, including a questionnaire for health care utilization. The impact of depression on health care costs was analyzed using multiple linear regression models. A societal perspective was adopted. RESULTS: Prevalence of depression was 10.7%. Mean total costs per six-month period were €8,144 (95% CI: €6,199-€10,090 in patients with depression as compared to €3,137 (95% CI: €2,735-€3,538; p<0.001 in patients without depression. The positive association between depression and total costs persisted after controlling for socio-economic variables, functional status and level of multimorbidity. In particular, multiple regression analyses showed a significant positive association between depression and pharmaceutical costs. CONCLUSION: Among multimorbid elderly patients, depression was associated with significantly higher health care utilization and costs. The effect of depression on costs was even greater than reported by previous studies conducted in less morbid patients.

Impulsive and compulsive behaviors among Danish patients with Parkinson's disease: prevalence, depression, and personality.

Science.gov (United States)

Callesen, M B; Weintraub, D; Damholdt, M F; Møller, A

2014-01-01

Dopaminergic medication administered to ameliorate motor symptoms of Parkinson's disease is associated with impulse control disorders, such as pathological gambling, hypersexuality, compulsive buying, and binge eating. Studies indicate a prevalence of impulse control disorders in Parkinson's disease of 6-16%. To estimate the prevalence of impulsive and compulsive behaviors among Danish patients with Parkinson's disease and to explore the relation of such behavioral disorders to depression and personality. 490 patients with Parkinson's disease (303 males), identified through the National Danish Patient Registry, were evaluated with: 1) the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease; 2) the Geriatric Depression Scale; and 3) the NEO-Personality Inventory. 176 (35.9%) patients reported impulsive and compulsive behaviors sometime during Parkinson's disease (current symptoms in 73, 14.9%). Hereof, 114 (23.3%) reported multiple behavioral symptoms. Patients with behavioral symptoms were significantly younger, were younger at PD onset, had longer disease duration, displayed more motor symptoms, and received higher doses of dopaminergic medication than patients without behavioral symptoms. Furthermore, they reported significantly more depressive symptoms and scored significantly higher on neuroticism and lower on both agreeableness and conscientiousness than patients without behavioral symptoms. A history of impulsive and compulsive behaviors are common in Danish patients with Parkinson's disease and have clinical correlates that may allow identification of patients at risk for developing these behaviors. Copyright © 2013 Elsevier Ltd. All rights reserved.

Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil.

Science.gov (United States)

Nogueira, Eduardo Lopes; Rubin, Leonardo Librelotto; Giacobbo, Sara de Souza; Gomes, Irenio; Cataldo Neto, Alfredo

2014-06-01

OBJECTIVE To analyze the prevalence of depression in older adults and associated factors. METHODS Cross-sectional study using a stratified random sample of 621 individuals aged ≥ 60 from 27 family health teams in Porto Alegre, RS, Southern Brazil, between 2010 and 2012. Community health agents measured depression using the 15-item Geriatric Depression Scale. Scores of ≥ 6 were considered as depression and between 11 and 15 as severe depression. Poisson regression was used to search for independent associations of sociodemographic and self-perceived health with both depression and its severity. RESULTS The prevalence of depression was 30.6% and was significantly higher in women (35.9% women versus 20.9% men, p education, especially illiteracy (PR = 1.8, 95%CI 1.2;2 6); regular self-rated health (OR = 2.2, 95%CI 1.6;3.0); and poor/very poor self-rated health (PR = 4.0, 95%CI 2.9;5.5). Except for education, the strength of association of these factors increases significantly in severe depression. CONCLUSIONS A high prevalence of depression was observed in the evaluations conducted by community health agents, professionals who are not highly specialized. The findings identified using the 15-item Geriatric Depression Scale in this way are similar to those in the literature, with depression more associated with low education, female gender and worse self-rated health. From a primary health care strategic point of view, the findings become still more relevant, indicating that community health agents could play an important role in identifying depression in older adults.

American Geriatrics Society

Science.gov (United States)

... Learn More Social Media Facebook Twitter LinkedIn Instagram Social Media Bar Right Menu Annual Meeting Donate to our Foundation Contact Us American Geriatrics Society 40 Fulton St., 18th Floor New York, NY ...

Comprehensive geriatric assessment

African Journals Online (AJOL)

2007-09-14

Sep 14, 2007 ... i.e. difficulty performing simple physical and mental tasks necessary for daily life. ... Definition. Comprehensive geriatric assessment (CGA) is a multidimensional .... The formation of a programme of therapy is decided on.

Costs of medication in older patients: before and after comprehensive geriatric assessment

Directory of Open Access Journals (Sweden)

Unutmaz GD

2018-04-01

Full Text Available Gulcin Done Unutmaz,1 Pinar Soysal,2 Busra Tuven,1 Ahmet Turan Isik3 1Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Geriatric Center Kayseri Education and Research Hospital, Kayseri, Turkey; 3Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Background: Polypharmacy and inappropriate drug use cause numerous complications, such as cognitive impairment, frailty, falls, and functional dependence. The present study aimed to determine the effect of the comprehensive geriatric assessment (CGA on polypharmacy, potentially inappropriate medications (PIMs and potential prescribing omissions (PPOs, and to evaluate the economic reflections of medication changes.Methods: One thousand five hundred and seventy-nine older patients, who had undergone CGA, were retrospectively evaluated. The drugs, drug groups, and number of drugs that the patients used were recorded. Appropriate drug therapy was identified by both CGA and STOPP/START criteria. Based on these criteria, PIMs were discontinued and PPOs were started. The monthly cost of these drugs was calculated separately for PIMs and PPOs by using the drugstore records.Results: After CGA, while the prevalence of non-polypharmacy was increased from 43.3% to 65.6%, the prevalence of polypharmacy and hyperpolypharmacy was decreased from 56.7% to 34.4% and 12.0% to 3.6%, respectively. The three most common PIMs discontinued were proton pump inhibitors, anti-dementia drugs, and antipsychotics, respectively. However, the most common PPOs started were vitamin D and B12 supplements, and anti-depressants. After CGA, monthly saved total per capita cost of PIMs was US$12.8 and monthly increased total per capita cost of PPOs was $5.6.Conclusion: It was demonstrated that prevalence of polypharmacy, PIM, and PPO could be decreased by CGA including START/STOPP criteria in older adults. Furthermore, this will have beneficial effects on

Magnitude of depression and its determinants among older persons in urban community of Agra

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Anshumali Singh

2018-03-01

Full Text Available Background: With increasing life expectancy people are living longer but they are not necessarily healthier than before. Nearly a quarter (23% of the overall global burden of death and illness is in people aged over 60, and much of this burden is attributable to long-term illness like non-communicable diseases and mental health problems. Aims & Objectives: Aim of the study the magnitude of depression among elderly population of Agra. Objectives To estimate the prevalence of depression in elderly population of Agra. 2. To study the factors associated with depression among elderly population of Agra. Material and Methods: This study was conducted among 355 elderly in urban Agra. Data was collected by house to house visit using pre-designed and pre-tested schedule. Geriatric depression scale (GDS-30 was used to assess the burden of depression in study population.  Results: The mean age of the study participants was 68.05 years. Depression was found in 50.1% among study population and 15.5% had severe depression. Depression was more among the Illiterates, Muslims, financial dependents, those who were suffering from chronic disease/s, encountered a stressor in the last 6 months, less religious, not living with partner or suffered elderly abuse.  Conclusion: High burden of depression was found among the victims of elderly abuse. Stressful life events and absence of spouse were found to be significant risk factors for depression. To deal with these factors we suggest a link worker Geriatric Age Social Health Agent (G-ASHA to act as a link between family, community and authorities.

Assessment of mental health and illness by telephone survey: experience with an Alberta mental health survey.

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Patten, Scott B; Adair, Carol E; Williams, Jeanne Va; Brant, Rollin; Wang, Jian Li; Casebeer, Ann; Beauséjour, Pierre

2006-01-01

Mental health is an emerging priority for health surveillance. It has not been determined that the existing data sources can adequately meet surveillance needs. The objective of this project was to explore the use of telephone surveys as a means of collecting supplementary surveillance information. A computer-assisted telephone interview was administered to 5,400 subjects in Alberta. The interview included a set of brief, validated measures for evaluating mental disorder prevalence and related variables. The individual subject response rate was 78 percent, but a substantial number of refusals occurred at the initial household contact. The age and sex distribution of the study sample differed from that of the provincial population prior to weighting. Prevalence proportions did not vary substantially across administrative health regions. There is a potential role for telephone data collection in mental health surveillance, but these results highlight some associated methodological challenges. They also draw into question the importance of regional variation in mental disorder prevalence--which might otherwise have been a key advantage of telephone survey methodologies.

Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

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Whitehead JC

2015-06-01

Full Text Available Jocelyne C Whitehead,1 Sara A Gambino,1 Jeffrey D Richter,2 Jennifer D Ryan1,3,41Rotman Research Institute, Baycrest, 2Independent Human Factors Consultant, Toronto, ON, Canada; 3Department of Psychology, 4Department of Psychiatry, University of Toronto, Toronto, ON, CanadaObjective: This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current tools.Methods: Two focus group sessions were conducted with nurses and physicians who routinely administer neurocognitive assessments to geriatric populations. Video recordings of the focus group sessions were transcribed and a thematic analysis was performed.Results: Participants reported the need for assessment and diagnostic tools that are accessible and efficient, and that are capable of accommodating the rapid growth in the aging population. The prevalence of more complex ailments experienced by older adults has had repercussions in the quality of care that the clients receive, and has contributed to lengthy wait times and resource shortages. Health-care professionals stated that they are hampered by the disjointed structure of the health-care system and that they would benefit from a more efficient allocation of responsibilities made possible through tools that did not require extensive training or certification. Eyetracking-based cognitive assessments were thought to strongly complement this system, yet it was thought that difficulty would be faced in gaining the support and increased uptake by health-care professionals due to the nonintuitive relationship between eyetracking and cognition.Conclusion: The findings suggest that health-care professionals are receptive to the use of eyetracking technology to assess for cognitive health as it would conserve resources by allowing frontline staff to administer assessments with minimal training

Academic detailing to teach aging and geriatrics.

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Duckett, Ashley; Cuoco, Theresa; Pride, Pamela; Wiley, Kathy; Iverson, Patty J; Marsden, Justin; Moran, William; Caton, Cathryn

2015-01-01

Geriatric education is a required component of internal medicine training. Work hour rules and hectic schedules have challenged residency training programs to develop and utilize innovative teaching methods. In this study, the authors examined the use of academic detailing as a teaching intervention in their residents' clinic and on the general medicine inpatient wards to improve clinical knowledge and skills in geriatric care. The authors found that this teaching method enables efficient, directed education without disrupting patient care. We were able to show improvements in medical knowledge as well as self-efficacy across multiple geriatric topics.

Validation of a brief telephone battery for neurocognitive assessment of patients with pulmonary arterial hypertension

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Palevsky Harold I

2005-04-01

Full Text Available Abstract Background The effects of pulmonary arterial hypertension on brain function are not understood, despite patients' frequent complaints of cognitive difficulties. Using clinical instruments normally administered during standard in-person assessment of neurocognitive function in adults, we assembled a battery of tests designed for administration over the telephone. The purpose was to improve patient participation, facilitate repeated test administration, and reduce the cost of research on the neuropsychological consequences of acute and chronic cardiorespiratory diseases. We undertook this study to validate telephone administration of the tests. Methods 23 adults with pulmonary arterial hypertension underwent neurocognitive assessment using both standard in-person and telephone test administration, and the results of the two methods compared using interclass correlations. Results For most of the tests in the battery, scores from the telephone assessment correlated strongly with those obtained by in-person administration of the same tests. Interclass correlations between 0.5 and 0.8 were observed for tests that assessed attention, memory, concentration/working memory, reasoning, and language/crystallized intelligence (p ≤ 0.05 for each. Interclass correlations for the Hayling Sentence Completion test of executive function approached significance (p = 0.09. All telephone tests were completed within one hour. Conclusion Administration of this neurocognitive test battery by telephone should facilitate assessment of neuropsychological deficits among patients with pulmonary arterial hypertension living across broad geographical areas, and may be useful for monitoring changes in neurocognitive function in response to PAH-specific therapy or disease progression.

Frailty and geriatric syndromes in elderly assisted in primary health care

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Vera Elizabeth Closs

2016-06-01

Full Text Available The aim of this study was to describe the association between frailty and geriatric syndromes (GS [cognitive impairment (CI; postural instability (PI; urinary/fecal incontinence (UFI; polypharmacy (PP; and immobility (IM] and the frequency of these conditions in elderly people assisted in primary health care. Five hundred twenty-one elderly participants of The Multidimensional Study of the Elderly in the Family Health Strategy (EMI-SUS were evaluated. Sociodemographic data, identification of frailty (Fried phenotype and GS were collected. Multinomial logistic regression analysis was performed. The frequency of frailty was 21.5%, prefrailty 51.1% and robustness 27.4%. The frequency of CI was 54.7%, PP 41.2%, PI 36.5%, UFI 14% and IM 5.8%. The odds of frailty when compared to robustness and adjusted for gender, age, depression, self-perception of health, nutritional status, falls, vision and hearing, was significantly higher in elderly with CI, PI and PP. The adjusted odds of prefrail when compared to robustness was significantly higher only in elderly with CI. The most frequently presented number of GS (0-5 was two geriatric syndromes (26.87%. The frequency of frailty was high among elderly in primary health care and was associated with three of five GS (CI - PI - PP.

Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study.

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Guerra, Mariella; Ferri, Cleusa P; Sosa, Ana Luisa; Salas, Aquiles; Gaona, Ciro; Gonzales, Victor; de la Torre, Gabriela Rojas; Prince, Martin

2009-12-01

The proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide. To estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America. A one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM-IV and ICD-10 criteria, Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) algorithm and EURO-D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD-10 depression. For DSM-IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD-10 depressive episode between 4.5% and 5.1%, for GMS-AGECAT depression between 30.0% and 35.9% and for EURO-D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD-10 and DSM-IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD-10 depressive episode. The treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector.

Hypobaric spinal anesthesia in the operative management of orthopedic emergencies in geriatric patients.

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Sidi, A; Pollak, D; Floman, Y; Davidson, J T

1984-07-01

Hypobaric spinal anesthesia was administered to 40 patients undergoing lower limb surgery. Twenty-nine of the patients were debilitated geriatric patients who presented with orthopedic emergencies, in most cases a fractured hip. Hypobaric spinal anesthesia was found to be a simple and safe procedure that provided adequate analgesia. Due to its inherent nature, hypobaric spinal anesthesia does not necessitate positioning of the patient on the injured, painful side (unlike hyperbaric spinal or epidural anesthesia) and, therefore, facilitates a smooth and painless transfer of the patient to the operating table. Complications encountered were similar to those following hyperbaric anesthesia.

Depression among older people in Europe: the EURODEP studies

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Copeland, John RM; Beekman, Aartjan TF; Braam, Arjan W; Dewey, Michael E; Delespaul, Philippe; Fuhrer, Rebecca; Hooijer, Christopher; Lawlor, Brian A; Kivela, Sirkka-Liisa; Lobo, Anthony; Magnusson, Halgrimur; Mann, Anthony H; Meller, Ingeborg; Prince, Martin J; Reischies, Friedel

2004-01-01

The data from nine centres in Europe which had used the Geriatric Mental Scale (GMS) AGECAT were analysed to compare prevalence of diagnoses in subjects aged 65 years and over living in the community. Levels of depressive illness were: Iceland 8.8%, Liverpool 10.0%; Zaragoza 10.7%; Dublin 11.9%; Amsterdam 12.0%; Berlin 16.5%; London 17.3%; Verona 18.3% and Munich 23.6%. Taking all levels of depression, five high (Amsterdam, Berlin, Munich, London and Verona) and four low (Du...

The clinical utility of the Cornell Scale for Depression in Dementia as a routine assessment in nursing homes.

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Jeon, Yun-Hee; Li, Zhicheng; Low, Lee-Fay; Chenoweth, Lynn; O'Connor, Daniel; Beattie, Elizabeth; Liu, Zhixin; Brodaty, Henry

2015-08-01

To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes. 14 nursing homes in Sydney and Brisbane, Australia. 92 residents with a mean age of 85 years. Consenting residents were assessed by care staff for depression using the CSDD as part of their routine assessment. Specialist clinicians conducted assessment of depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders for residents without dementia or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease for residents with dementia to establish expert clinical diagnoses of depression. The diagnostic performance of the staff completed CSDD was analyzed against expert diagnosis using receiver operating characteristic (ROC) curves. The CSDD showed low diagnostic accuracy, with areas under the ROC curve being 0.69, 0.68 and 0.70 for the total sample, residents with dementia and residents without dementia, respectively. At the standard CSDD cutoff score, the sensitivity and specificity were 71% and 59% for the total sample, 69% and 57% for residents with dementia, and 75% and 61% for residents without dementia. The Youden index (for optimizing cut-points) suggested different depression cutoff scores for residents with and without dementia. When administered by nursing home staff the clinical utility of the CSDD is highly questionable in identifying depression. The complexity of the scale, the time required for collecting relevant information, and staff skills and knowledge of assessing depression in older people must be considered when using the CSDD in nursing homes. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Association between religiosity/spirituality and quality of life or depression among living-alone elderly in a South Korean city.

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Moon, Yoo Sun; Kim, Do Hoon

2013-12-01

This study investigated the effects of religiosity and spirituality on quality of life and depression among older people. Two hundred and seventy-four solitary elderly people aged over 65 years living in Chuncheon city, South Korea were selected. Symptoms of depression were evaluated using the Short Geriatric Depression Scale-Korean version (SGDS-K) and quality of life was measured using Geriatric Quality of Life-Dementia (GQOL-D). We used the Duke Religion Index (DUREL) to assess religiosity and spirituality. There was a significant correlation between scales of depression (SGDS-K), quality of life (GQOL-D), and scale of religiosity/spirituality (DUREL) in older people. Depressed people had a lower score GQOL-D than non-depressed people. Among the depressed, those believing in a religion had a higher GQOL-D score than the non-religious. Multiple regression analysis revealed that religiosity and spirituality had significant effects on depression and quality of life among the elderly. Interestingly, religiosity and spirituality were not related to depression and quality of life amongst Buddhists, but were related amongst Protestants and Catholics. Religiosity and spirituality had significant effects on depression and on quality of life among the Korean elderly. However, there are different relationships between depression and religiosity, quality of life, and religiosity based on different religions. More research is needed to elucidate these findings. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Short assessment of the Big Five: robust across survey methods except telephone interviewing

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Lang, Frieder R.; John, Dennis; Lüdtke, Oliver; Schupp, Jürgen; Wagner, Gert G.

2011-01-01

We examined measurement invariance and age-related robustness of a short 15-item Big Five Inventory (BFI–S) of personality dimensions, which is well suited for applications in large-scale multidisciplinary surveys. The BFI–S was assessed in three different interviewing conditions: computer-assisted or paper-assisted face-to-face interviewing, computer-assisted telephone interviewing, and a self-administered questionnaire. Randomized probability samples from a large-scale German panel survey a...

Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.

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Camina-Martín, M Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, J Antonio; Redondo-del-Río, M Paz

2015-07-01

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. Copyright © 2015 Elsevier Ireland Ltd. All rights

[Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group].

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Camina-Martín, María Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, José Antonio; Redondo-Del-Río, María Paz

2016-01-01

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. Copyright © 2015 SEGG. Published by Elsevier

An Overview of Otorhinolaryngeal Problems in Geriatrics

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Girija Shankar Mohanta

2018-06-01

Full Text Available Summary: Background: The increase of geriatric population, as well as their age-related problems, is of great concern for the society and for the governments all over the world and also in India. The main objectives were to overview and find the prevalence of Oto-rhino-laryngological problems in the geriatric population. Method: A prospective study of geriatric patients was undertaken in ENT & HNS Department, S.C.B Medical College & Hospital, Cuttack, India, from November 2014 to August 2016.Inclusion criteria –The patients of age 60 yrs & above who attended ENT outpatient department were studied. Among 3563 patients studied, 363 patients were admitted. The patients were segregated according to sex (male/female, ages (60–64 yr group, 65–69 yr group, 70 yr & above, disease ratio, and prevalence of diseases, associated co-morbidities, and socio-economic aspects. Results: Total patients studied were 3563. The otological problems were being prevalent in geriatrics among study population (51.77% in which presbycusis was the highest with 17.71% of total and 34.21% of otological problems. The problems related to nose were 13.03%, among which epistaxis was 4.98% of total and 37.60% of nasal problems. The neck and throat problems were 35.20%. The problems were more in males (63.65% than in females (36.35%. Conclusion: The hearing loss is the most prevalent diagnosis amongst all otologic problems and epistaxis amongst nasal symptoms. The emergence of head & neck cancers among the geriatric population is a great concern in a developing country like India. Keywords: Oto-rhino-laryngological problems, geriatric populations

The oncologic and the geriatric patient

International Nuclear Information System (INIS)

Philotheou, Geraldine M

2002-01-01

The oncologic and the geriatric patient have special needs in the nuclear medicine department. The nuclear medicine technologists must be knowledgeable and compassionate when dealing with these patients. The diagnosis of cancer will have a sociological and psychological impact on the patient, to which the technologist must relate in an empathetic way. Furthermore, the technologist should take cognisance of the patient's physical condition and be able to modify the examination accordingly. Dealing with the geriatric patient should be correctly placed on the continuum between a gerontological and geriatric approach taking into consideration normal changes due to aging. The patient experience when undergoing the high technology nuclear medicine diagnostic procedure is unique and all effort must be made to ensure the success of the examination and the satisfaction of the patient (Au)

Are depression and frailty overlapping syndromes in mid- and late-life? A latent variable analysis.

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Mezuk, Briana; Lohman, Matthew; Dumenci, Levent; Lapane, Kate L

2013-06-01

Depression and frailty both predict disability and morbidity in later life. However, it is unclear to what extent these common geriatric syndromes represent overlapping constructs. To examine the joint relationship between the constructs of depression and frailty. Data come from 2004-2005 wave of the Baltimore Epidemiologic Catchment Area Study, and the analysis is limited to participants 40 years and older, with complete data on frailty and depression indicators (N = 683). Depression was measured using the Diagnostic Interview Schedule, and frailty was indexed by modified Fried criteria. A series of confirmatory latent class analyses were used to assess the degree to which depression and frailty syndromes identify the same populations. A latent kappa coefficient (κl) was also estimated between the constructs. Confirmatory latent class analyses indicated that depression and frailty represent distinct syndromes rather than a single construct. The joint modeling of the two constructs supported a three-class solution for depression and two-class solution for frailty, with 2.9% categorized as severely depressed, 19.4% as mildly depressed, and 77.7% as not depressed, and 21.1% categorized as frail and 78.9% as not frail. The chance-corrected agreement statistic indicated moderate correspondence between the depression and frailty constructs (κl: 66, 95% confidence interval: 0.58-0.74). Results suggest that depression and frailty are interrelated concepts, yet their operational criteria identify substantively overlapping subpopulations. These findings have implications for understanding factors that contribute to the etiology and prognosis of depression and frailty in later life. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Predoctoral Teaching of Geriatric Dentistry in U.S. Dental Schools.

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Ettinger, Ronald L; Goettsche, Zachary S; Qian, Fang

2017-08-01

The aim of this study was to assess the current teaching of geriatric dentistry in U.S. dental schools and compare the findings to previous reports. Academic deans at all 67 U.S. dental schools were contacted in November 2015 via email, asking them to complete a questionnaire about the teaching of geriatric dentistry or gerodontology at their institution. Questionnaires were received from 56 of the 67 schools (84% response rate). The results showed that geriatric dentistry was taught in all responding schools; for 92.8% of the respondents, the instruction was compulsory. Among the responding schools, 62.5% were teaching it as an independent course, 25% as an organized series of lectures, and 8.9% as occasional lectures in parts of other courses. In addition, 57.1% had some form of compulsory clinical education in geriatric dentistry. Public schools, as opposed to private schools, were marginally associated with an increased interest in expanding geriatric dentistry teaching (p=0.078). No differences were found between any teaching variables and school location. This study found that the form of education in geriatric dentistry in U.S. dental schools differed in many ways, but the teaching of geriatric dentistry had increased among all respondents and had been increasing for over 30 years. Future research is needed to determine the impact of this teaching on services to the geriatric community.

Telephone-Based Cognitive-Behavioral Screening for Frontotemporal Changes in Patients with Amyotrophic Lateral Sclerosis (ALS)

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Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R.; Mitsumoto, Hiroshi

2017-01-01

Objective To establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the phone. Methods Thirty-one subjects were administered either in-person or telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Results Equivalence testing was performed for in-person and telephone-based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level when compared to a revised phone-version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). Conclusions Our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone-based cognitive testing for ALS could become an integral resource for population-based research in the future. PMID:27121545

Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

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Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

2013-01-01

Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P insomnia at follow-up (P insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362. PMID:23450712

Emergency Department Pain Management Following Implementation of a Geriatric Hip Fracture Program

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Scott D. Casey

2017-04-01

Full Text Available Introduction: Over 300,000 patients in the United States sustain low-trauma fragility hip fractures annually. Multidisciplinary geriatric fracture programs (GFP including early, multimodal pain management reduce morbidity and mortality. Our overall goal was to determine the effects of a GFP on the emergency department (ED pain management of geriatric fragility hip fractures. Methods: We performed a retrospective study including patients age ≥65 years with fragility hip fractures two years before and two years after the implementation of the GFP. Outcomes were time to (any first analgesic, use of acetaminophen and fascia iliaca compartment block (FICB in the ED, and amount of opioid medication administered in the first 24 hours. We used permutation tests to evaluate differences in ED pain management following GFP implementation. Results: We studied 131 patients in the pre-GFP period and 177 patients in the post-GFP period. In the post-GFP period, more patients received FICB (6% vs. 60%; difference 54%, 95% confidence interval [CI] 45–63%; p<0.001 and acetaminophen (10% vs. 51%; difference 41%, 95% CI 32–51%; p<0.001 in the ED. Patients in the post-GFP period also had a shorter time to first analgesic (103 vs. 93 minutes; p=0.04 and received fewer morphine equivalents in the first 24 hours (15mg vs. 10mg, p<0.001 than patients in the pre-GFP period. Conclusion: Implementation of a GFP was associated with improved ED pain management for geriatric patients with fragility hip fractures. Future studies should evaluate the effects of these changes in pain management on longer-term outcomes.

Comparison of quality of sleep, depression, and life satisfaction between older adults in nursing homes and long-term care hospitals in Korea.

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Kim, Kon Hee; Hwang, Eun Hee

2017-01-01

The purpose of the present study was to identify the sleep quality, depression, and life satisfaction between nursing home and long-term care hospital residents. Data was collected through a structured questionnaire survey of 61 nursing home residents and 74 long-term care hospital residents. Descriptive statistics, t-test, χ 2 -test, anova, Pearson's correlation were used to analyze the data. The residents living in a nursing home showed higher subjective health status and sleep quality than long-term care hospital residents. Depression did not show a significant difference between them. However, there was a significant difference in depression score by subjective health status. Sleep quality and depression showed a significant negative correlation for both residents. In terms of depression and life satisfaction, nursing home residents showed a significant negative correlation, and long-term care hospital residents showed a significant positive correlation. These results show that environmental management is essential to enhance sleep quality, thus depression and subjective health status will be improved. Geriatr Gerontol Int 2017; 17: 142-149. © 2015 Japan Geriatrics Society.

Approach to the pressure sores in geriatric patients

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Emre İnözü

2012-09-01

Full Text Available Objectives: The aim of this study was to evaluate the follow-up results of nutritionally supported geriatric patientswho were admitted for their pressure sores then plannedtheir treatment.Materials and methods: In this study, we analyzed thehospitalized geriatric pressure sore patients in our clinicwho were admitted between 2006 and 2011. We calculatedBody Mass Index and the blood albumin levels of allhospitalized geriatric patients. In this patient group proteinenergy malnutrition and deficiency were analyzed andproper nutrition support was provided accordingly. Afterrecovering from malnutrition further treatment surpassed.Results: The mean albumin levels of the hospitalized patientswas 2,53 ± 0,25 g/dL after nutritional support thoselevels increased to mean 3,95 ± 0,42 g/dL . Of all thosepatients 75% were operated when their general conditionallowed us for a surgery. Due to their high risk wedid not perform any surgical operation to the remaining25%.. Post operative mean hospitalization period was 12(8-21 days. Majority of the patients (78.6% were treatedsuccessfully either with surgical or conservative treatmentmodalities.Conclusions: The success of the geriatric pressure soretreatment is highly related with the proper nutritional supportfor the ongoing malnutrition-like pathologies. Beforeoperation nutritional support not only makes a healthygranulation tissue but also yields fast and reliable woundhealing. Despite their chronic health problems many ofour geriatric patients were treated surgically for their pressuresores.Key words: Pressure sore, geriatric medicine, malnutrition,nutritional support

Telephone calls by individuals with cancer.

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Flannery, Marie; McAndrews, Leanne; Stein, Karen F

2013-09-01

To describe symptom type and reporting patterns found in spontaneously initiated telephone calls placed to an ambulatory cancer center practice. Retrospective, descriptive. Adult hematology oncology cancer center. 563 individuals with a wide range of oncology diagnoses who initiated 1,229 telephone calls to report symptoms. Raw data were extracted from telephone forms using a data collection sheet with 23 variables obtained for each phone call, using pre-established coding criteria. A literature-based, investigator-developed instrument was used for the coding criteria and selection of which variables to extract. Symptom reporting, telephone calls, pain, and symptoms. A total of 2,378 symptoms were reported by telephone during the four months. At least 10% of the sample reported pain (38%), fatigue (16%), nausea (16%), swelling (12%), diarrhea (12%), dyspnea (10%), and anorexia (10%). The modal response was to call only one time and to report only one symptom (55%). Pain emerged as the symptom that most often prompted an individual to pick up the telephone and call. Although variation was seen in symptom reporting, an interesting pattern emerged with an individual reporting on a solitary symptom in a single telephone call. The emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone. Report of symptoms by telephone can provide nurses unique insight into patient-centered needs. Although pain has been an important focus of education and research for decades, it remains a priority for individuals with cancer. A wide range in symptom reporting by telephone was evident.

Graduate and Undergraduate Geriatric Dentistry Education in a Selected Dental School in Japan

Science.gov (United States)

Kitagawa, Noboru; Sato, Yuji; Komabayashi, Takashi

2010-01-01

Geriatric dentistry and its instruction are critical in a rapidly aging population. Japan is the world’s fastest-aging society, and thus geriatric dentistry education in Japan can serve as a global model for other countries that will soon encounter the issues that Japan has already confronted. This study aimed to evaluate geriatric dental education with respect to the overall dental education system, undergraduate geriatric dentistry curricula, mandatory internships, and graduate geriatric education of a selected dental school in Japan. Bibliographic data and local information were collected. Descriptive and statistical analyses (Fisher and Chi-square test) were conducted. Japanese dental schools teach geriatric dentistry in 10 geriatric dentistry departments as well as in prosthodontic departments. There was no significant differences found between the number of public and private dental schools with geriatric dentistry departments (p = 0.615). At Showa University School of Dentistry, there are more didactic hours than practical training hours; however, there is no significant didactic/practical hour distribution difference between the overall dental curriculum and fourth-year dental students’ geriatric dental education curriculum (p=0.077). Graduate geriatric education is unique because it is a four-year Ph.D. course of study; there is neither a Master’s degree program nor a certificate program in Geriatric Dentistry. Overall, both undergraduate and graduate geriatric dentistry curricula are multidisciplinary. This study contributes to a better understanding of geriatric dental education in Japan; the implications of this study include developing a clinical/didactic curriculum, designing new national/international dental public health policies, and calibrating the competency of dentists in geriatric dentistry. PMID:21985207

Fried frailty phenotype assessment components as applied to geriatric inpatients

Directory of Open Access Journals (Sweden)

Bieniek J

2016-04-01

Full Text Available Joanna Bieniek, Krzysztof Wilczynski, Jan Szewieczek Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Background: Management of geriatric patients would be simplified if a universally accepted definition of frailty for clinical use was defined. Among definitions of frailty, Fried frailty phenotype criteria constitute a common reference frame for many geriatric studies. However, this reference frame has been tested primarily in elderly patients presenting with relatively good health status. Objective: The aim of this article was to assess the usefulness and limitations of Fried frailty phenotype criteria in geriatric inpatients, characterized by comorbidity and functional impairments, and to estimate the frailty phenotype prevalence in this group. Patients and methods: Five hundred consecutive patients of the university hospital subacute geriatric ward, aged 79.0±8.4 years (67% women and 33% men, participated in this cross-sectional study. Comprehensive geriatric assessment and Fried frailty phenotype component evaluation were performed in all patients. Results: Multimorbidity (6.0±2.8 diseases characterized our study group, with a wide range of clinical conditions and functional states (Barthel Index of Activities of Daily Living 72.2±28.2 and Mini-Mental State Examination 23.6±7.1 scores. All five Fried frailty components were assessed in 65% of patients (95% confidence interval [CI] =60.8–69.2 (diagnostic group. One or more components were not feasible to be assessed in 35% of the remaining patients (nondiagnostic group because of lack of past patient’s body mass control and/or cognitive or physical impairment. Patients from the nondiagnostic group, as compared to patients from the diagnostic group, presented with more advanced age, higher prevalence of dementia, lower prevalence of hypertension, lower systolic and diastolic blood pressure, body mass index, Mini

Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial.

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Dennis, C-L; Hodnett, E; Kenton, L; Weston, J; Zupancic, J; Stewart, D E; Kiss, A

2009-01-15

To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression. Multisite randomised controlled trial. Seven health regions across Ontario, Canada. 701 women in the first two weeks postpartum identified as high risk for postnatal depression with the Edinburgh postnatal depression scale and randomised with an internet based randomisation service. Proactive individualised telephone based peer (mother to mother) support, initiated within 48-72 hours of randomisation, provided by a volunteer recruited from the community who had previously experienced and recovered from self reported postnatal depression and attended a four hour training session. Edinburgh postnatal depression scale, structured clinical interview-depression, state-trait anxiety inventory, UCLA loneliness scale, and use of health services. After web based screening of 21 470 women, 701 (72%) eligible mothers were recruited. A blinded research nurse followed up more than 85% by telephone, including 613 at 12 weeks and 600 at 24 weeks postpartum. At 12 weeks, 14% (40/297) of women in the intervention group and 25% (78/315) in the control group had an Edinburgh postnatal depression scale score >12 (chi(2)=12.5, P<0.001; number need to treat 8.8, 95% confidence interval 5.9 to 19.6; relative risk reduction 0.46, 95% confidence interval 0.24 to 0.62). There was a positive trend in favour of the intervention group for maternal anxiety but not loneliness or use of health services. For ethical reasons, participants identified with clinical depression at 12 weeks were referred for treatment, resulting in no differences between groups at 24 weeks. Of the 221 women in the intervention group who received and evaluated their experience of peer support, over 80% were satisfied and would recommend this support to a friend. Telephone based peer support can be effective in preventing postnatal depression among women at high risk. ISRCTN 68337727.

[Challenges of implementing a geriatric trauma network : A regional structure].

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Schoeneberg, Carsten; Hussmann, Bjoern; Wesemann, Thomas; Pientka, Ludger; Vollmar, Marie-Christin; Bienek, Christine; Steinmann, Markus; Buecking, Benjamin; Lendemans, Sven

2018-04-01

At present, there is a high percentage and increasing tendency of patients presenting with orthogeriatric injuries. Moreover, significant comorbidities often exist, requiring increased interdisciplinary treatment. These developments have led the German Society of Trauma Surgery, in cooperation with the German Society of Geriatrics, to establish geriatric trauma centers. As a conglomerate hospital at two locations, we are cooperating with two external geriatric clinics. In 2015, a geriatric trauma center certification in the form of a conglomerate network structure was agreed upon for the first time in Germany. For this purpose, the requirements for certification were observed. Both structure and organization were defined in a manual according to DIN EN ISO 9001:2015. Between 2008 and 2016, an increase of 70% was seen in geriatric trauma cases in our hospital, with a rise of up to 360% in specific diagnoses. The necessary standards and regulations were compiled and evaluated from our hospitals. After successful certification, improvements were necessary, followed by a planned re-audit. These were prepared by multiprofessional interdisciplinary teams and implemented at all locations. A network structure can be an alternative to classical cooperation between trauma and geriatric units in one clinic and help reduce possible staffing shortage. Due to the lack of scientific evidence, future evaluations of the geriatric trauma register should reveal whether network structures in geriatric trauma surgery lead to a valid improvement in medical care.

Salience Network and Depressive Severities in Parkinson's Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis.

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Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

2017-01-01

Purpose: In Parkinson's disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

Geriatric fall-related injuries | Hefny | African Health Sciences

African Journals Online (AJOL)

Background: Falls are the leading cause of geriatric injury. ... and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. Methods: All injured patients with an age ≥ 60 years who were admitted to ...

Feasibility and impact of telemonitor-based depression care management for geriatric homecare patients.

Science.gov (United States)

Sheeran, Thomas; Rabinowitz, Terry; Lotterman, Jennifer; Reilly, Catherine F; Brown, Suzanne; Donehower, Patricia; Ellsworth, Elizabeth; Amour, Judith L; Bruce, Martha L

2011-10-01

The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services. Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM and received biweekly supervision. On-site trained research assistants conducted in-home research interviews on depression diagnosis and severity and patient satisfaction with the protocol. An ethnically diverse sample of 48 English- and Spanish-only-speaking patients participated, along with seven telehealth nurses. Both patients and telehealth nurses reported high levels of protocol acceptance. Among 19 patients meeting diagnostic criteria for major depression, the mean depression severity was in the "markedly severe" range at baseline and in the "mild" range at follow-up. Results of this pilot support the feasibility of using homecare's existing telemonitoring technology to deliver DCM to their elderly homebound patients. This was true for both English- and Spanish-speaking patients. Preliminary clinical outcomes suggest improvement in depression severity, although these findings require testing in a randomized clinical trial. Implications for the science and service of telehealth-based depression care for elderly patients are discussed.

MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

OpenAIRE

Cokorda Istri Devi Larayanthi

2013-01-01

Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, gene...

Geriatric consultation services-are wards more effective than teams?

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Cameron, Ian D; Kurrle, Susan

2013-02-22

Geriatric consultation teams are one of the models for bringing comprehensive geriatric assessment to vulnerable and frail older people in the acute care hospital setting. While ward-based comprehensive geriatric assessment has been established as effective with reference to improving functional status and other outcomes, the team-based variant remains unproven for outcomes other than mortality in the medium term, as shown in a recent study published in BMC Medicine by Deschodt and colleagues. Further research might establish the effectiveness of the team-based model but, for current clinical practice, the emphasis should be on streaming older people with complex problems needing multidisciplinary assessment and treatment to ward-based models of comprehensive geriatric assessment.

Predicting geriatric falls following an episode of emergency department care: a systematic review.

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Carpenter, Christopher R; Avidan, Michael S; Wildes, Tanya; Stark, Susan; Fowler, Susan A; Lo, Alexander X

2014-10-01

projected benefits or harms of fall prevention interventions in the ED. A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk. © 2014 by the Society for Academic Emergency Medicine.

Medical students' recognition and application of geriatrics principles in a new curriculum.

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Nanda, Aman; Farrell, Timothy W; Shield, Renée R; Tomas, Maria; Campbell, Susan E; Wetle, Terrie

2013-03-01

Given the aging U.S. population, it is imperative that medical students recognize and apply geriatrics principles. To address this need, in 2006, the Warren Alpert Medical School of Brown University integrated geriatrics content into a new medical school curriculum. Preclinical and clinical medical students submitted written reflective journals in response to prompts regarding the geriatrics content of the new medical school curriculum, including their didactic and clinical experiences. An interdisciplinary team used a structured qualitative approach to identify themes, including the recognition and application of geriatrics principles. Thirty medical student journalers submitted 405 journal entries. Themes regarding students' emerging understanding of geriatrics principles included a growing understanding of geriatrics principles, recognition of the importance of psychosocial factors and patient preferences in caring for older adults, recognition of the complexities of treating older adults and application of geriatric principles to clinical situations, and understanding of physicians' roles in managing the care of older adults. Medical student reflective journaling allows medical educators to obtain timely feedback on curricular innovations and helps illuminate the process by which medical students learn to recognize and apply core geriatrics principles. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Lean business model and implementation of a geriatric fracture center.

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Kates, Stephen L

2014-05-01

Geriatric hip fracture is a common event associated with high costs of care and often with suboptimal outcomes for the patients. Ideally, a new care model to manage geriatric hip fractures would address both quality and safety of patient care as well as the need for reduced costs of care. The geriatric fracture center model of care is one such model reported to improve both outcomes and quality of care. It is a lean business model applied to medicine. This article describes basic lean business concepts applied to geriatric fracture care and information needed to successfully implement a geriatric fracture center. It is written to assist physicians and surgeons in their efforts to implement an improved care model for their patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Gender Differences in Rating Stressful Events, Depression, and Depressive Cognition.

Science.gov (United States)

Sowa, Claudia J.; Lustman, Patrick J.

1984-01-01

Administered the Life Stress Questionnaire, the Beck Depression Inventory, and the Automatic Thought Questionnaire to 140 students. Results showed significant sex differences. Men reported more stressful life change, but women rated the impact of stressors more severely and had higher depression. Men exhibited greater distortions in cognitive…

Feasibility and Impact of Telemonitor-Based Depression Care Management for Geriatric Homecare Patients

Science.gov (United States)

Rabinowitz, Terry; Lotterman, Jennifer; Reilly, Catherine F.; Brown, Suzanne; Donehower, Patricia; Ellsworth, Elizabeth; Amour, Judith L.; Bruce, Martha L.

2011-01-01

Abstract Objective The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services. Materials and Methods Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM and received biweekly supervision. On-site trained research assistants conducted in-home research interviews on depression diagnosis and severity and patient satisfaction with the protocol. Results An ethnically diverse sample of 48 English- and Spanish-only–speaking patients participated, along with seven telehealth nurses. Both patients and telehealth nurses reported high levels of protocol acceptance. Among 19 patients meeting diagnostic criteria for major depression, the mean depression severity was in the “markedly severe” range at baseline and in the “mild” range at follow-up. Conclusions Results of this pilot support the feasibility of using homecare's existing telemonitoring technology to deliver DCM to their elderly homebound patients. This was true for both English- and Spanish-speaking patients. Preliminary clinical outcomes suggest improvement in depression severity, although these findings require testing in a randomized clinical trial. Implications for the science and service of telehealth-based depression care for elderly patients are discussed. PMID:21780942

Brain levels of high-energy phosphate metabolites and executive function in geriatric depression.

Science.gov (United States)

Harper, David G; Joe, Elizabeth B; Jensen, J Eric; Ravichandran, Caitlin; Forester, Brent P

2016-11-01

Depression in late life has been associated with difficulties in cognitive processing, particularly in the domains of executive function, processing speed and memory, and increases the risk of developing dementia suggesting a neurodegenerative phenotype. Mitochondrial dysfunction is frequently an early event in neurodegenerative illnesses and may be operative in patients with late life depression. Phosphorus magnetic resonance spectroscopy (31P MRS) allows for the quantification of bioenergetic molecules produced by mitochondria. Ten patients with late life depression and eight normal elderly controls were studied with Stroop color and interference tests, which are widely used measures of processing speed and executive function, respectively, followed by (31P) MRS 3-dimensional chemical-shift imaging measuring levels of adenosine triphosphate, phosphocreatine, inorganic phosphate, and pH over the whole brain. In all subjects, gray matter phosphocreatine was positively associated with Stroop interference. Levels of white matter adenosine triphosphate were associated with Stroop interference in subjects with late life depression but not normal elderly. There was also a complementary association between white matter inorganic phosphate and Stroop interference in late life depression patients. These findings suggest two independent sources of executive function dependence on bioenergetic state in the aging brain. The dependence of executive function performance in subjects with late life depression on ATP in white matter may be associated with mitochondrial impairment and is consistent with predictions of the vascular depression hypothesis. Further research with wider neuropsychological testing targeting bioenergetic markers could help clarify the scope of these effects. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Topologically convergent and divergent structural connectivity patterns between patients with remitted geriatric depression and amnestic mild cognitive impairment.

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Bai, Feng; Shu, Ni; Yuan, Yonggui; Shi, Yongmei; Yu, Hui; Wu, Di; Wang, Jinhui; Xia, Mingrui; He, Yong; Zhang, Zhijun

2012-03-21

Alzheimer's disease (AD) can be conceptualized as a disconnection syndrome. Both remitted geriatric depression (RGD) and amnestic mild cognitive impairment (aMCI) are associated with a high risk for developing AD. However, little is known about the similarities and differences in the topological patterns of white matter (WM) structural networks between RGD and aMCI. In this study, diffusion tensor imaging and deterministic tractography were used to map the human WM networks of 35 RGD patients, 38 aMCI patients, and 30 healthy subjects. Furthermore, graph theoretical methods were applied to investigate the alterations in the global and regional properties of the WM network in these patients. First, both the RGD and aMCI patients showed abnormal global topology in their WM networks (i.e., reduced network strength, reduced global efficiency, and increased absolute path length) compared with the controls, and there were no significant differences in these global network properties between the patient groups. Second, similar deficits of the regional and connectivity characteristics in the WM networks were primarily found in the frontal brain regions of RGD and aMCI patients compared with the controls, while a different nodal efficiency of the posterior cingulate cortex and several prefrontal brain regions were also observed between the patient groups. Together, our study provides direct evidence for the association of a great majority of convergent and a minority of divergent connectivity of WM structural networks between RGD and aMCI patients, which may lead to increasing attention in defining a population at risk of AD.

Characteristics of depression in community-dwelling elderly people as indicated by the tree-drawing test.

Science.gov (United States)

Murayama, Norio; Endo, Tadashi; Inaki, Koichiro; Sasaki, Shinsai; Fukase, Yuko; Ota, Kazumi; Iseki, Eizo; Tagaya, Hirokuni

2016-07-01

The tree-drawing test (TDT) is a typical projective method, but previous studies have paid little attention to it for elderly people. We investigated the characteristics of depression in community-dwelling elderly people as indicated by the TDT. This study was a complete enumeration survey of elderly people conducted through home visits. The contents of the survey included gender, age, presence or absence of housemates, frequency of going out, the 15-item Geriatric Depression Scale, and TDT. The subjects were divided into three groups (normal, depressed tendency, and depressed) according to the total 15-item Geriatric Depression Scale score. In TDT, no significant difference was observed in drooping crown, shadow of the whole tree, or shadow near the base, which have been regarded as indices of depression in younger people. However, the values concerning the size of the tree, such as the height and width of the whole tree, height and width of the crown, and number of occupied areas (of the paper), were significantly lower in the depressed group than in the other groups. In addition, the width of the trunk was significantly smaller in the depressed group than in the normal group. Subjects were classified as being in a 'depressed state' if they used 40 or fewer areas for drawing (i.e. occupied areas) and a 'non-depressed state' if they used 41 or more areas. This enabled depression to be detected (sensitivity: 71.4%; specificity: 79.9%). The size of the tree in TDT is suggested to reflect characteristics of depression in elderly people, such as introversion, reserve, antisocial attitude, a feeling of inferiority, weakness of ego, and lack of vigour. Furthermore, the numbers of occupied areas were found to be relatively useful in detecting depression in elderly people. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Predictive validity of the Hendrich fall risk model II in an acute geriatric unit.

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Ivziku, Dhurata; Matarese, Maria; Pedone, Claudio

2011-04-01

Falls are the most common adverse events reported in acute care hospitals, and older patients are the most likely to fall. The risk of falling cannot be completely eliminated, but it can be reduced through the implementation of a fall prevention program. A major evidence-based intervention to prevent falls has been the use of fall-risk assessment tools. Many tools have been increasingly developed in recent years, but most instruments have not been investigated regarding reliability, validity and clinical usefulness. This study intends to evaluate the predictive validity and inter-rater reliability of Hendrich fall risk model II (HFRM II) in order to identify older patients at risk of falling in geriatric units and recommend its use in clinical practice. A prospective descriptive design was used. The study was carried out in a geriatric acute care unit of an Italian University hospital. All over 65 years old patients consecutively admitted to a geriatric acute care unit of an Italian University hospital over 8-month period were enrolled. The patients enrolled were screened for the falls risk by nurses with the HFRM II within 24h of admission. The falls occurring during the patient's hospital stay were registered. Inter-rater reliability, area under the ROC curve, sensitivity, specificity, positive and negative predictive values and time for the administration were evaluated. 179 elderly patients were included. The inter-rater reliability was 0.87 (95% CI 0.71-1.00). The administration time was about 1min. The most frequently reported risk factors were depression, incontinence, vertigo. Sensitivity and specificity were respectively 86% and 43%. The optimal cut-off score for screening at risk patients was 5 with an area under the ROC curve of 0.72. The risk factors more strongly associated with falls were confusion and depression. As falls of older patients are a common problem in acute care settings it is necessary that the nurses use specific validate and reliable

Physical frailty predicts incident depressive symptoms in elderly people: prospective findings from the Obu Study of Health Promotion for the Elderly.

Science.gov (United States)

Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Yoshida, Daisuke; Anan, Yuya; Tsutsumimoto, Kota; Uemura, Kazuki; Liu-Ambrose, Teresa; Park, Hyuntae; Lee, Sanyoon; Suzuki, Takao

2015-03-01

The purpose of this study was to determine whether frailty is an important and independent predictor of incident depressive symptoms in elderly people without depressive symptoms at baseline. Fifteen-month prospective study. General community in Japan. A total of 3025 community-dwelling elderly people aged 65 years or over without depressive symptoms at baseline. The self-rated 15-item Geriatric Depression Scale was used to assess symptoms of depression with a score of 6 or more at baseline and 15-month follow-up. Participants underwent a structural interview designed to obtain demographic factors and frailty status, and completed cognitive testing with the Mini-Mental State Examination and physical performance testing with the Short Physical Performance Battery as potential predictors. At a 15-month follow-up survey, 226 participants (7.5%) reported the development of depressive symptoms. We found that frailty and poor self-rated general health (adjusted odds ratio 1.86, 95% confidence interval 1.30-2.66, P Examination, Short Physical Performance Battery, and Geriatric Depression Scale scores at baseline. Our findings suggested that frailty and poor self-rated general health were independent predictors of depressive symptoms in community-dwelling elderly people. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Acute Chloroform Ingestion Successfully Treated with Intravenously Administered N-acetylcysteine

OpenAIRE

Dell’Aglio, Damon M.; Sutter, Mark E.; Schwartz, Michael D.; Koch, David D.; Algren, D. A.; Morgan, Brent W.

2010-01-01

Chloroform, a halogenated hydrocarbon, causes central nervous system depression, cardiac arrhythmias, and hepatotoxicity. We describe a case of chloroform ingestion with a confirmatory serum level and resultant hepatotoxicity successfully treated with intravenously administered N-acetylcysteine (NAC). A 19-year-old man attempting suicide ingested approximately 75 mL of chloroform. He was unresponsive and intubated upon arrival. Intravenously administered NAC was started after initial stabiliz...

76 FR 54536 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-09-01

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

78 FR 55778 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

Science.gov (United States)

2013-09-11

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting.... App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

77 FR 49865 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

Science.gov (United States)

2012-08-17

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

A prospective study assessing agreement and reliability of a geriatric evaluation

OpenAIRE

Locatelli, Isabella; Monod, St?fanie; Cornuz, Jacques; B?la, Christophe J.; Senn, Nicolas

2017-01-01

Background The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation. Method...

Telephone versus face-to-face administration of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for diagnosis of psychotic disorders.

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Hajebi, Ahmad; Motevalian, Abbas; Amin-Esmaeili, Masoumeh; Hefazi, Mitra; Radgoodarzi, Reza; Rahimi-Movaghar, Afarin; Sharifi, Vandad

2012-07-01

The current study aims to compare telephone vs face-to-face administration of the version of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (SCID) for diagnosis of "any psychotic disorder" in a clinical population in Iran. The sample consisted of 72 subjects from 2 psychiatric outpatient services in Tehran, Iran. The subjects were interviewed using face-to-face SCID for the purpose of diagnosing psychotic disorders. A second independent telephone SCID was administered to the entire sample within 5 to 10 days, and the lifetime and 12-month diagnoses were compared. The positive likelihood ratio of telephone-administered SCID for diagnosis of "any lifetime psychotic disorder" was 5.1 when compared with the face-to-face SCID. The value for the primary psychotic disorders in the past 12 months was lower (2.3). The data indicate that telephone administration of the SCID is an acceptable method to differentiate between subjects with lifetime psychotic disorders and those who have had no psychotic disorders and provides a less resource-demanding alternative to face-to-face assessments. Copyright © 2012 Elsevier Inc. All rights reserved.

Pesticide exposure and self-reported incident depression among wives in the Agricultural Health Study.

Science.gov (United States)

Beard, John D; Hoppin, Jane A; Richards, Marie; Alavanja, Michael C R; Blair, Aaron; Sandler, Dale P; Kamel, Freya

2013-10-01

Depression in women is a public health problem. Studies have reported positive associations between pesticides and depression, but few studies were prospective or presented results for women separately. We evaluated associations between pesticide exposure and incident depression among farmers' wives in the Agricultural Health Study, a prospective cohort study in Iowa and North Carolina. We used data on 16,893 wives who did not report physician-diagnosed depression at enrollment (1993-1997) and who completed a follow-up telephone interview (2005-2010). Among these wives, 1054 reported physician diagnoses of depression at follow-up. We collected information on potential confounders and on ever use of any pesticide, 11 functional and chemical classes of pesticides, and 50 specific pesticides by wives and their husbands via self-administered questionnaires at enrollment. We used inverse probability weighting to adjust for potential confounders and to account for possible selection bias induced by the death or loss of 10,639 wives during follow-up. We used log-binomial regression models to estimate risk ratios and 95% confidence intervals. After weighting for age at enrollment, state of residence, education level, diabetes diagnosis, and drop out, wives' incident depression was positively associated with diagnosed pesticide poisoning, but was not associated with ever using any pesticide. Use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' depression. Among wives who never used pesticides, husbands' ever use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' incident depression. Our study adds further evidence that high level pesticide exposure, such as pesticide poisoning, is associated with increased risk of depression and sets a lower bound on the level of exposure related to depression, thereby providing reassurance that the moderate levels

76 FR 17999 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

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2011-03-31

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 14... pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care facilities...

75 FR 54232 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

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2010-09-03

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care facilities...

77 FR 14860 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

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2012-03-13

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 11... matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care...

75 FR 11638 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

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2010-03-11

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 22... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

78 FR 6406 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

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2013-01-30

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting.... App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 10... matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care...

Development of statewide geriatric patients trauma triage criteria.

Science.gov (United States)

Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

2011-06-01

The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

[Geriatric rehabilitation care: Doing the right things right].

Science.gov (United States)

de Vos, A J B M; van Balen, R; Gobbens, R J J; Bakker, T J E M

2018-02-01

Geriatric rehabilitation concerns short-term integrated multidisciplinary care aimed at functional recovery and social participation for relatively frail elderly. Given the geriatric clients' complex care issues, nurses should possess sufficient and appropriate competencies in order to identify and assess the relevant symptoms and intervene effectively. Yet, nurses experience a certain apprehensiveness to perform their tasks and express difficulties in multidisciplinary communication and collaboration in a constructive manner. In addition to the client's and informal care giver's perception of their input in the geriatric rehabilitation process, this study provides an in-depth understanding of the way nurses perceive their role in geriatric rehabilitation. This descriptive study entails a quantitative and a qualitative component. The quantitative component concerns questionnaires for clients, informal care givers, nurses, and team leaders. The qualitative component aims to obtain in-depth information (i. e. opinions, meanings, and reflections) with regard to the decision making process and the performance of the rehabilitation care by means of open-ended questions (in the questionnaire) and semi-structured interviews. Clients and informal care givers rate specific themes in geriatric rehabilitation in a more negative light than nurses and team leaders do. These themes concern the provision of information in the hospital (prior to admission in the rehabilitation facility), involvement in the draw-up of the treatment plan and rehabilitation goals, geriatric rehabilitation as a 24/7 activity, and taking into account the client's other life events. The latter three findings in particular, are caused by nurses' apprehensiveness to perform their tasks adequately. Nurses working in geriatric rehabilitation, experience apprehensiveness to perform their tasks adequately. Uncertainty about the client's reaction or fear of damaging the relationship of trust, results

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Wednesday 14 June between 8.00 p.m. and midnight. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Feasibility of Ecological Momentary Assessment Using Cellular Telephones in Methamphetamine Dependent Subjects

Directory of Open Access Journals (Sweden)

John Mendelson

2008-01-01

Full Text Available Background: Predictors of relapse to methamphetamine use are poorly understood. State variables may play an important role in relapse, but they have been difficult to measure at frequent intervals in outpatients.Methods: We conducted a feasibility study of the use of cellular telephones to collect state variable data from outpatients. Six subjects in treatment for methamphetamine dependence were called three times per weekday for approximately seven weeks. Seven questionnaires were administered that assessed craving, stress, affect and current type of location and social environment.Results: 395/606 (65% of calls attempted were completed. The mean time to complete each call was 4.9 (s.d. 1.8 minutes and the mean time to complete each item was 8.4 (s.d. 4.8 seconds. Subjects rated the acceptability of the procedures as good. All six cellular phones and battery chargers were returned undamaged.Conclusion: Cellular telephones are a feasible method for collecting state data from methamphetamine dependent outpatients.

Confiabilidade e validade da escala de depressão geriátrica em idosos com doença arterial coronariana Confiabilidad y validez de la escala de depresión geriátrica en adultos mayores con enfermedad arterial coronaria Reliability and validity of the geriatric depression scale in elderly individuals with coronary artery disease

Directory of Open Access Journals (Sweden)

Míriam Ximenes Pinho

2010-05-01

Full Text Available FUNDAMENTO: A prevalência de depressão em portadores de doença arterial coronariana (DAC é alta. A escala de depressão geriátrica (EDG é um instrumento amplamente usado para rastrear a depressão em idosos. No Brasil, as propriedades psicométricas da versão curta ainda não foram adequadamente exploradas. OBJETIVO: Avaliar as propriedades psicométricas da versão curta da EDG em portadores de DAC em ambulatório de cardiologia. MÉTODOS: Estudo transversal que avaliou 209 idosos (≥ 65 anos com DAC utilizando a EDG-15, Cumulative Illness Rating Scale for Geriatrics (CIRS, Brazilian OARS Multidimensional Function Assessment Questionnaire (BOMFAQ e The Cambridge Examination for Mental Disorders of the Elderly (CAMDEX. A consistência interna da EDG-15 foi calculada pelo KR-20. Uma análise fatorial dessa escala foi conduzida. Escores da EDG-15 foram comparados com os diagnósticos de depressão (DSM-IV para a validade de critérios. Na análise de validade concorrente, os mesmos escores foram correlacionados com os das escalas de depressão CAMDEX, Miniexame do Estado Mental (MEEM, Cambridge Cognitive Examination (CAMCOG e BOMFAQ. RESULTADOS: A depressão clínica foi diagnosticada em 35,71% da amostra avaliada de acordo com o DSM-IV. Para o diagnóstico de depressão maior ou distimia, o ponto de corte 5/6 apresentou acurácia moderada (AUROC = 0,84, sensibilidade de 79,92% e especificidade de 78,29%. A consistência interna foi de 0,80. Na análise fatorial, três fatores obtidos explicaram 52,72% da variância total observada. Os escores da EDG-15 correlacionaram-se com os da escala de depressão CAMDEX. CONCLUSÃO: No geral, a EDG-15 apresentou boa confiabilidade e validade (concorrente e de critério. Em settings cardiológicos, seu uso pode auxiliar no rastreamento de quadros depressivos de forma simples e rápida.FUNDAMENTO: La prevalencia de depresión en portadores de enfermedad arterial coronaria (EAC es alta. La escala de

[The relationship between depressive symptoms and family functioning in institutionalized elderly].

Science.gov (United States)

de Oliveira, Simone Camargo; dos Santos, Ariene Angelini; Pavarini, Sofia Cristina Iost

2014-02-01

The present study aimed to investigate the relationship between family functioning and depressive symptoms among institutionalized elderly. This is a descriptive, cross-sectional study of quantitative character. A total of 107 institutionalized elderly were assessed using a sociodemographic questionnaire, the Geriatric Depression Scale (to track depressive symptoms) and the Family APGAR (to assess family functioning). The correlation coefficient of Pearson's, the chi-square test and the crude and adjusted logistic regression were used in the data analysis with a significance level of 5 %. The institutionalized elderly with depressive symptoms were predominantly women and in the age group of 80 years and older. Regarding family functioning, most elderly had high family dysfunctioning (57 %). Family dysfunctioning was higher among the elderly with depressive symptoms. There was a significant correlation between family functioning and depressive symptoms. The conclusion is that institutionalized elderly with dysfunctional families are more likely to have depressive symptoms.

Evidence-Based Practice Guideline: Depression Detection in Older Adults With Dementia.

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Brown, Ellen Leslie; Raue, Patrick J; Halpert, Karen

2015-11-01

Depression and dementia are the two most common psychiatric syndromes in the older adult population. Depression in older adults with and without dementia often goes unrecognized and untreated. The current guideline recommends a three-step procedure that can be used across health care settings to screen for the presence of depressive symptoms. Implementation of the evidence-based guideline requires administration of the Mini-Mental State Examination and either the Geriatric Depression Scale Short Form or Cornell Scale for Depression in Dementia, depending on level of cognitive functioning. The algorithm provided is designed to be used by nurses, physicians, and social workers for the purpose of depression screening in older adults with dementia. Detection of depression in individuals with dementia is hindered by a lack of a validated, brief screening tool. More research is needed on the use of such screenings among older adults with cognitive impairment. Copyright 2015, SLACK Incorporated.

Report on a Program Evaluation of a Telephone Assisted Parenting Support Service for Families Living in Isolated Rural Areas.

Science.gov (United States)

Cann, Warren; Rogers, Helen; Worley, Greg

2003-01-01

This brief report evaluates a pilot project to deliver a telephone supported, self-directed parenting program to isolated families. The aim of the project was to promote the competence and confidence of parents experiencing early difficulties. Significant improvements were noted in child behavior, parenting style, parental depression, anxiety, and…

The cost of dysphagia in geriatric patients

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Westmark S

2018-06-01

Full Text Available Signe Westmark,1 Dorte Melgaard,1,2 Line O Rethmeier,3 Lars Holger Ehlers3 1Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; 2Department of Physiotherapy and Occupational Therapy, North Denmark Regional Hospital, Hjørring, Denmark; 3Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark Objectives: To estimate the annual cost at the hospital and in the municipality (social care due to dysphagia in geriatric patients.Design: Retrospective cost analysis of geriatric patients with dysphagia versus geriatric patients without dysphagia 1 year before hospitalization.Setting: North Denmark Regional Hospital, Hjørring Municipality, Frederikshavn Municipality, and Brønderslev Municipality.Subjects: A total of 258 hospitalized patients, 60 years or older, acute hospitalized in the geriatric department.Materials and methods: Volume-viscosity swallow test and the Minimal Eating Observation Form-II were conducted for data collection. A Charlson Comorbidity Index score measured comorbidity, and functional status was measured by Barthel-100. To investigate the cost of dysphagia, patient-specific data on health care consumption at the hospital and in the municipality (nursing, home care, and training were collected from medical registers and records 1 year before hospitalization including the hospitalization for screening for dysphagia. Multiple linear regression analyses were conducted to determine the relationship between dysphagia and hospital and municipality costs, respectively, adjusting for age, gender, and comorbidity.Results: Patients with dysphagia were significantly costlier than patients without dysphagia in both hospital (p=0.013 and municipality costs (p=0.028 compared to patients without dysphagia. Adjusted annual hospital costs in patients with dysphagia were 27,347 DKK (3,677 EUR, 4,282 USD higher than patients without dysphagia at the hospital, and annual health care costs in the

Association between the prevalence of depression and age in a large representative German sample of people aged 53 to 80 years.

Science.gov (United States)

Wild, Beate; Herzog, Wolfgang; Schellberg, Dieter; Lechner, Sabine; Niehoff, Doro; Brenner, Hermann; Rothenbacher, Dietrich; Stegmaier, Christa; Raum, Elke

2012-04-01

The aim of the study was to determine the association between the prevalence of clinically significant depression and age in a large representative sample of elderly German people. In the second follow-up (2005-2007) of the ESTHER cohort study, the 15-item geriatric depression scale (GDS-15) as well as a sociodemographic and clinical questionnaire were administered to a representative sample of 8270 people of ages 53 to 80 years. The prevalence of clinically significant depression was estimated using a GDS cut-off score of 5/6. Prevalence rates were estimated for the different age categories. Association between depression and age was analyzed using logistic regression, adjusted for gender, co-morbid medical disorders, education, marital status, physical activity, smoking, self-perceived cognitive impairment, and anti-depressive medication. Of the participants, 7878 (95.3%) completed more than twelve GDS items and were included in the study. The prevalence of clinically significant depression was 16.0% (95%CI = [15.2; 16.6]). The function of depression prevalence dependent on age group showed a U-shaped pattern (53-59: 21.0%, CI = [18.9; 23.3]; 60-64: 17.7%, CI = [15.7; 19.7]; 65-69: 12.6%, CI = [11.2; 14.0]; 70-74: 14.4%, CI = [12.6; 16.0]; 75-80: 17.1%, CI = [14.9; 19.4]). Adjusted odds ratios showed that the chances of being depressive decrease with the age category but remain relatively stable for people aged 65 and over. The prevalence of depression in the elderly seems to be associated with the age category. Adjusted odds ratios showed that people aged 60 and older had lower chances of being depressive than people aged 53 to 59 years. Copyright © 2011 John Wiley & Sons, Ltd.

Depression in older Chinese migrants to Auckland.

Science.gov (United States)

Abbott, Max W; Wong, Sai; Giles, Lynne C; Wong, Sue; Young, Wilson; Au, Ming

2003-08-01

This study was conducted to identify risk factors for depressive symptomatology among older Chinese migrants. One hundred and sixty-two Chinese migrants aged 55 years or older, living in the community and recruited via Chinese community organizations and general practitioners, were interviewed using a Chinese version of the Geriatric Depression Scale and measures of stressful life events, morbid conditions, self-rated health, acculturation, social support and service utilization. Twenty-six percent of participants met the criteria for depressive symptomatology. No recent migrants showed symptoms of depression. Multiple logistic regression analysis showed that lower emotional support, greater number of visits to a doctor, difficulties in accessing health services and low New Zealand cultural orientation increased the risk of showing symptoms of depression. Significant numbers of older Chinese migrants appear to be depressed or at risk for depression and, while participants with depressive symptoms consulted general practitioners more than their counterparts without such symptoms, they reported greater difficulty in accessing health services. The findings point to the need for further epidemiological study of this growing sector of the population and investigation of the nature of its engagement with health services. Social support and aspects of acculturation may play a significant role in preventing depression. This also requires further investigation.

Fried frailty phenotype assessment components as applied to geriatric inpatients

OpenAIRE

Bieniek, Joanna; Wilczy?ski, Krzysztof; Szewieczek, Jan

2016-01-01

Joanna Bieniek, Krzysztof Wilczynski, Jan Szewieczek Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Background: Management of geriatric patients would be simplified if a universally accepted definition of frailty for clinical use was defined. Among definitions of frailty, Fried frailty phenotype criteria constitute a common reference frame for many geriatric studies. However, this reference frame has been tested primarily in ...

Geriatric Oncology Program Development and Gero-Oncology Nursing.

Science.gov (United States)

Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

2016-02-01

To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of Alzheimer's-Type Dementia and Information Source on the Assessment of Depression.

Science.gov (United States)

Gilley, David W.; And Others

1995-01-01

The level of agreement between the patient and a collateral source with regard to depressive symptomatology was compared for 185 patients with Alzheimer's-type dementia (AD), 57 patients with Parkinson's disease, and 54 nondemented geriatric referrals. Findings highlight the potential insensitivity of patient report in AD. (SLD)

Dental Students' Self-Assessed Competence in Geriatric Dentistry.

Science.gov (United States)

Kiyak, H. Asuman; Brudvik, James

1992-01-01

A study of four classes of dental students (n=172) exposed to both didactic and clinical geriatric dental training found that the students perceived significant improvements in their abilities to manage geriatric patients in all areas assessed, notably treatment planning, preventive dentistry, referrals, and providing care in alternative settings.…

Psychological background of prevention and treatment in geriatrics

Directory of Open Access Journals (Sweden)

Nazarov M.l.

2015-03-01

Full Text Available Confidentiality as the component of an interpersonal "patient — medical practitioner" contact formation can be considered as a corner stone of geriatric practice. Major psychological pitfalls of geriatric practice have been reviewed. The main issue of the paper is psychological substantiation of treatment and prevention of elderly.

Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts.

Science.gov (United States)

Mohile, Supriya Gupta; Velarde, Carla; Hurria, Arti; Magnuson, Allison; Lowenstein, Lisa; Pandya, Chintan; O'Donovan, Anita; Gorawara-Bhat, Rita; Dale, William

2015-09-01

Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes. Copyright © 2015 by the National Comprehensive Cancer Network.

Depressive symptoms in institutionalized older adults

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Lívia Maria Santiago

2014-04-01

Full Text Available OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals.

A study of geriatric depression and co- morbidities among primary ...

African Journals Online (AJOL)

Depression in the elderly is very common but diagnostic rates among primary care physicians is poor. This is attributed to both patient and physician related factors. The patient factors include co-morbidities, aging and psychological mindedness which is culture related. Generally, there's paucity of psychological complaints ...

Pycnogenol Ameliorates Depression-Like Behavior in Repeated Corticosterone-Induced Depression Mice Model

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Lin Mei

2014-01-01

Full Text Available Oxidative stress is considered to be a mechanism of major depression. Pycnogenol (PYC is a natural plant extract from the bark of Pinus pinaster Aiton and has potent antioxidant activities. We studied the ameliorative effect of PYC on depression-like behavior in chronic corticosterone- (CORT- treated mice for 20 days. After the end of the CORT treatment period, PYC (0.2 mg/mL was orally administered in normal drinking water. Depression-like behavior was investigated by the forced swimming test. Immobility time was significantly longer by CORT exposure. When the CORT-treated mice were supplemented with PYC, immobility time was significantly shortened. Our results indicate that orally administered PYC may serve to reduce CORT-induced stress by radical scavenging activity.

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation.We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 20 November. Fixed-line telephone and audioconference services may be disrupted while the work is being carried out. However, the CCC and the fire brigade will be contactable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. For further details about the maintenance work, please contact the telephone switchboard on 76111 or by email to standard.telephone@cern.ch. Telecom Section IT/CS

Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (OGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013

DEFF Research Database (Denmark)

Singler, K.; Stuck, A. E.; Masud, T.

2014-01-01

using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end...... at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties...

Curriculum content in geriatric dentistry in USA dental schools.

Science.gov (United States)

Ettinger, Ronald L; Goettsche, Zachary S; Qian, Fang

2018-03-01

The aim of this study was to re-examine the teaching of geriatric dentistry in the USA dental schools, to identify curriculum content and compare the findings to previous reports. All dental schools in the United States were contacted via email with a questionnaire to assess the teaching of geriatric dentistry. Non-responding schools were sent a minimum of three reminder emails to complete the survey. A statistical analysis was performed. Descriptive statistics were conducted to profile the variables of interest. Bivariate analysis was performed to explore if any of the variables were related using Fisher's exact test, non-parametric Wilcoxon rank-sum test and the Kruskal-Wallis test. Fifty-six of the 67 dental schools completed the questionnaire. Geriatric dentistry was taught in all dental schools; for 92.8%, the course was compulsory. We found that 62.5% were teaching it as an independent course, 25% as an organised series of lectures and 8.9% as occasional lectures in parts of other courses. Clinically, 84.2% have some form of compulsory education in geriatric dentistry. Public schools were marginally associated with an increased interest in expanding the geriatric dentistry curriculum (P = .078). No differences were found between these variables and school location. Geriatric dentistry is now required in 92.8% of dental schools. The teaching of traditional topics has not changed much; however, the number of gerontological topics has increased. Clinical teaching needs to be expanded, as in only 57.1% of schools was it a requirement. The ageing imperative will require research to determine the impact of teaching on services to the geriatric community. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Remission in Depressed Geriatric Primary Care Patients: A Report From the PROSPECT Study

Science.gov (United States)

Alexopoulos, George S.; Katz, Ira R.; Bruce, Martha L.; Heo, Moonseong; Have, Thomas Ten; Raue, Patrick; Bogner, Hillary R.; Schulberg, Herbert C.; Mulsant, Benoit H.; Reynolds, Charles F.

2009-01-01

Objective This study compared time to first remission for elderly depressed patients in primary care for practices that implemented a care management model versus those providing usual care. In addition, it sought to identify risk factors for nonremission that could guide treatment planning and referral to care managers or specialists. Method Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) data were analyzed. Participants were older patients (≥60 years) selected following screening of 9,072 randomly identified primary care patients. The present analysis examined patients with major depression and a 24-item Hamilton Depression Rating Scale score of 18 or greater who were followed for at least 4 months (N=215). Primary care practices were randomly assigned to offer the PROSPECT intervention or usual care. The intervention consisted of services of trained care managers, who offered algorithm-based recommendations to physicians and helped patients with treatment adherence over 18 months. Results First remission occurred earlier and was more common among patients receiving the intervention than among those receiving usual care. For all patients, limitations in physical and emotional functions predicted poor remission rate. Patients experiencing hopelessness were more likely to achieve remission if treated in intervention practices. Similarly, the intervention was more effective in patients with low baseline anxiety. Conclusions Longitudinal assessment of depression, hopelessness, anxiety, and physical and emotional functional limitations in depressed older primary care patients is critical. Patients with prominent symptoms or impairment in these areas may be candidates for care management or mental health care, since they are at risk for remaining depressed and disabled. PMID:15800144

Update of telephone exchange

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2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Upgrade of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, work will be carried out on the CERN switching centre between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

Directory of Open Access Journals (Sweden)

Peters, Claudia

2014-09-01

Full Text Available [english] Background: The increase of multidrug-resistant organisms (MDROs causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff.Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs.Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution.Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work.

Interrelationship of motivation for and perceived constraints to physical activity participation and the well-being of senior center participants

Science.gov (United States)

Motoko Miyake; Ellen Rodgers

2009-01-01

This study investigated the relationship of motivation for and perceived constraints to physical activity (PA) participation and the well-being of senior center participants. A survey instrument made up of modified versions of the Sport Motivation and Perceived Constraints Scales, the Life Satisfaction Index-Z, and the Geriatric Depression Scale was administered at the...

[Geriatric intensive care patients : Perspectives and limits of geriatric intensive care medicine].

Science.gov (United States)

Müller-Werdan, U; Heppner, H-J; Michels, G

2018-04-18

Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age. The main reasons for changes in therapeutic targets are the will of the patient and risk-benefit considerations. The guidelines of the ethics section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) provide assistance and suggestions for a structured decision-making process.

Development and psychometric testing of a new geriatric spiritual well-being scale.

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Dunn, Karen S

2008-09-01

Aims and objectives.  Assess the psychometric properties of a new geriatric spiritual well-being scale (GSWS), specifically designed for older adults. Background.  Religiosity and spiritual wellness must be measured as two distinct concepts to prevent confounding them as synonymous among atheist and agnostic population. Design.  A test-retest survey design was used to estimate the psychometric properties. Methods.  A convenience sample of 138 community-dwelling older adults was drawn from the inner city of Detroit. Data were collected using telephone survey interviews. Data analyses included descriptive statistics, structural equation modelling, reliability analyses, and point-biserial correlations. Results.  The factorial validity of the proposed model was not supported by the data. Fit indices were χ(2)  = 185.98, d.f. = 98, P atheists have spiritual needs that do not include religious beliefs or practices. Thus, assessing patients' religious beliefs and practices prior to assessing spiritual well-being is essential to prevent bias. © 2008 The Author. Journal compilation © 2008 Blackwell Publishing Ltd.

Effect of in-hospital comprehensive geriatric assessment (CGA in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

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Taraldsen Kristin

2011-04-01

Full Text Available Abstract Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914

Exercise Promotion in Geriatric Oncology.

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Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

2016-09-01

Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.

Positive and negative volume-outcome relationships in the geriatric trauma population.

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Matsushima, Kazuhide; Schaefer, Eric W; Won, Eugene J; Armen, Scott B; Indeck, Matthew C; Soybel, David I

2014-04-01

In trauma populations, improvements in outcome are documented in institutions with higher case volumes. However, it is not known whether improved outcomes are attributable to the case volume within specific higher-risk groups, such as the elderly, or to the case volume among all trauma patients treated by an institution. To test the hypothesis that outcomes of trauma care for geriatric patients are affected differently by the volume of geriatric cases and nongeriatric cases of an institution. This retrospective cohort study using a statewide trauma registry was set in state-designated levels 1 and 2 trauma centers in Pennsylvania. It included 39 431 eligible geriatric trauma patients (aged >65 years) in the Pennsylvania Trauma Outcomes Study. In-hospital mortality, major complications, and mortality after major complications (failure to rescue). Between 2001 and 2010, 39 431 geriatric trauma patients and 105 046 nongeriatric patients were captured in a review of outcomes in 20 state-designated levels 1 and 2 trauma centers. Larger volumes of geriatric trauma patients were significantly associated with lower odds of in-hospital mortality, major complications, and failure to rescue. In contrast, larger nongeriatric trauma volumes were significantly associated with higher odds of major complications in geriatric patients. Higher rates of in-hospital mortality, major complications, and failure to rescue were associated with lower volumes of geriatric trauma care and paradoxically with higher volumes of trauma care for younger patients. These findings offer the possibility that outcomes might be improved with differentiated pathways of care for geriatric trauma patients.

[The mobile geriatrics team, global patient management].

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Bach, Fréderiue; Bloch, Frédéric

2013-01-01

The mobile geriatric team of Cochin hospital in Paris is responsible for the management and orientation of fragile elderly patients over the age of 75 admitted to emergency departments. It carries out a multi-disciplinary assessment, contributes to the creation of the care project and life project of geriatric patients and is involved in organising the patient's return home. This article focuses on the role of the social assistant through two clinical cases.

A Randomized Controlled Trial of In-Home Tele-Behavioral Health Care Utilizing Behavioral Activation for Depression

Science.gov (United States)

2016-05-01

therapy for depressed low-income homebound older adults. American Journal of Geriatric Psychiatry, 22, 263–271. doi:10.1016/j.jagp.2013.01.037 Cohen, S...frequently co-occurs with other conditions, such as PTSD and physical injuries among military personnel and Veterans and can slow recovery and return...the relative clinical efficacy of HBTBH. Key Words Behavioral Activation (BA) Cognitive Behavioral Therapy (CBT) Depression Military Post

The relationship between depressive symptoms and family functioning in institutionalized elderly

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Simone Camargo de Oliveira

2014-02-01

Full Text Available The present study aimed to investigate the relationship between family functioning and depressive symptoms among institutionalized elderly. This is a descriptive, cross-sectional study of quantitative character. A total of 107 institutionalized elderly were assessed using a sociodemographic questionnaire, the Geriatric Depression Scale (to track depressive symptoms and the Family APGAR (to assess family functioning. The correlation coefficient of Pearson’s, the chi-square test and the crude and adjusted logistic regression were used in the data analysis with a significance level of 5 %. The institutionalized elderly with depressive symptoms were predominantly women and in the age group of 80 years and older. Regarding family functioning, most elderly had high family dysfunctioning (57 %. Family dysfunctioning was higher among the elderly with depressive symptoms. There was a significant correlation between family functioning and depressive symptoms. The conclusion is that institutionalized elderly with dysfunctional families are more likely to have depressive symptoms.

Depression Case Finding in Individuals with Dementia: A Systematic Review and Meta-Analysis.

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Goodarzi, Zahra S; Mele, Bria S; Roberts, Derek J; Holroyd-Leduc, Jayna

2017-05-01

To compare the diagnostic accuracy of depression case finding tools with a criterion standard in the outpatient setting among adults with dementia. Systematic review and meta-analysis. Studies of older outpatients with dementia. Elderly outpatients (clinic and long-term care) with dementia (N = 3,035). Prevalence of major depression and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios. From the 11,539 citations, 20 studies were included for qualitative synthesis and 15 for a meta-analysis. Tools included were the Montgomery Åsberg Depression Rating Scale, Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Center for Epidemiologic Studies Depression Scale (CES-D), Hamilton Depression Rating Scale (HDRS), Single Question, Nijmegen Observer-Rated Depression Scale, and Even Briefer Assessment Scale-Depression. The pooled prevalence of depression in individuals with dementia was 30.3% (95% CI = 22.1-38.5). The average age was 75.2 (95% CI = 71.7-78.7), and mean Mini-Mental State Examination scores ranged from 11.2 to 24. The diagnostic accuracy of the individual tools was pooled for the best-reported cutoffs and for each cutoff, if available. The CSDD had a sensitivity of 0.84 (95% CI = 0.73-0.91) and a specificity of 0.80 (95% CI = 0.65-0.90), the 30-item GDS (GDS-30) had a sensitivity of 0.62 (95% CI = 0.45-0.76) and a specificity 0.81 (95% CI = 0.75-0.85), and the HDRS had a sensitivity of 0.86 (95% CI = 0.63-0.96) and a specificity of 0.84 (95% CI = 0.76-0.90). Summary statistics for all tools across best-reported cutoffs had significant heterogeneity. There are many validated tools for the detection of depression in individuals with dementia. Tools that incorporate a physician interview with patient and collateral histories, the CSDD and HDRS, have higher sensitivities, which would ensure fewer false-negatives. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

Senile anorexia in different geriatric settings in Italy.

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Donini, L M; Dominguez, L J; Barbagallo, M; Savina, C; Castellaneta, E; Cucinotta, D; Fiorito, A; Inelmen, E M; Sergi, G; Enzi, G; Cannella, C

2011-11-01

Anorexia is the most frequent modification of eating habits in old age, which may lead to malnutrition and consequent morbidity and mortality in older adults. We aimed to estimate the prevalence and factors associated to anorexia in a sample of Italian older persons living in different settings. Our secondary aim was to evaluate the impact of senile anorexia on nutritional status and on eating habits, as well as on functional status. Observational study in nursing homes, in rehabilitation and acute geriatric wards, and in the community in four Italian regions (Lazio, Sicily, Emilia-Romagna, and Veneto). 526 over 65 years old participants were recruited; 218 free-living subjects, 213 from nursing homes, and 96 patients from rehabilitation and acute geriatric wards in the context of a National Research Project (PRIN) from the Italian Ministry of Instruction, University and Research (2005-067913 "Cause e Prevalenza dell'Anoressia senile"). Anthropometric and nutritional evaluation, olfactory, chewing, and swallowing capacity, food preferences, cognitive function, functional status, depression, quality of life, social aspects, prescribed drugs, and evaluation of gastrointestinal symptoms and pain. Laboratory parameters included prealbumin, albumin, transferrin, C-reactive protein, mucoprotein, lymphocyte count, as well as neurotransmitters leptin, and ghrelin. Anorexia was considered as ≥50% reduction in food intake vs. a standard meal (using 3-day "Club Francophone de Gériatrie et Nutrition" form), in absence of oral disorders preventing mastication. The overall prevalence of anorexia was 21.2% with higher values among hospitalized patients (34.1% women and 27.2% men in long-term facilities; 33.3% women and 26.7% men in rehabilitation and geriatric wards; 3.3% women and 11.3% men living in the community) and in the oldest persons. Anorexic subjects were significantly less self-sufficient and presented more often a compromised nutritional and cognitive status. Diet

78 FR 12831 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting Amendment

Science.gov (United States)

2013-02-25

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting....S.C. App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee has been... and the Under Secretary for Health on all matters pertaining to geriatrics and gerontology. The...

Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

Directory of Open Access Journals (Sweden)

Ya-Ting Chang

2018-01-01

Full Text Available Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI, we investigated the clinical significance of salience network (SN in depression and cognitive performance.Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS: PD-MCI with depression (PD-MCI-D or without depression (PD-MCI-ND. The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores.Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046.Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

Science.gov (United States)

Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

2018-01-01

Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI. PMID:29375361

Older adults in jail: high rates and early onset of geriatric conditions.

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Greene, Meredith; Ahalt, Cyrus; Stijacic-Cenzer, Irena; Metzger, Lia; Williams, Brie

2018-02-17

The number of older adults in the criminal justice system is rapidly increasing. While this population is thought to experience an early onset of aging-related health conditions ("accelerated aging"), studies have not directly compared rates of geriatric conditions in this population to those found in the general population. The aims of this study were to compare the burden of geriatric conditions among older adults in jail to rates found in an age-matched nationally representative sample of community dwelling older adults. This cross sectional study compared 238 older jail inmates age 55 or older to 6871 older adults in the national Health and Retirement Study (HRS). We used an age-adjusted analysis, accounting for the difference in age distributions between the two groups, to compare sociodemographics, chronic conditions, and geriatric conditions (functional, sensory, and mobility impairment). A second age-adjusted analysis compared those in jail to HRS participants in the lowest quintile of wealth. All geriatric conditions were significantly more common in jail-based participants than in HRS participants overall and HRS participants in the lowest quintile of net worth. Jail-based participants (average age of 59) experienced four out of six geriatric conditions at rates similar to those found in HRS participants age 75 or older. Geriatric conditions are prevalent in older adults in jail at significantly younger ages than non-incarcerated older adults suggesting that geriatric assessment and geriatric-focused care are needed for older adults cycling through jail in their 50s and that correctional clinicians require knowledge about geriatric assessment and care.

Systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a service representative

Science.gov (United States)

Harris, Scott H.; Johnson, Joel A.; Neiswanger, Jeffery R.; Twitchell, Kevin E.

2004-03-09

The present invention includes systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a customer service representative. In one embodiment of the invention, a system configured to distribute a telephone call within a network includes a distributor adapted to connect with a telephone system, the distributor being configured to connect a telephone call using the telephone system and output the telephone call and associated data of the telephone call; and a plurality of customer service representative terminals connected with the distributor and a selected customer service representative terminal being configured to receive the telephone call and the associated data, the distributor and the selected customer service representative terminal being configured to synchronize, application of the telephone call and associated data from the distributor to the selected customer service representative terminal.

[Ten years of early complex geriatric rehabilitation therapy in the DRG system].

Science.gov (United States)

Kolb, G; Breuninger, K; Gronemeyer, S; van den Heuvel, D; Lübke, N; Lüttje, D; Wittrich, A; Wolff, J

2014-01-01

Geriatric medicine, as a specialized form of treatment for the elderly, is gaining in importance due to demographic changes. Especially important for geriatric medicine is combining acute care with the need to maintain functionality and participation. This includes prevention of dependency on structured care or chronic disability and handicap by means of rehabilitation. Ten years ago, the German DRG system tried to incorporate procedures (e.g., "early rehabilitation in geriatric medicine") in the hospital reimbursement system. OPS 8-550.x, defined by structural quality, days of treatment, and number of therapeutic interventions, triggers 17 different geriatric DRGs, covering most of the fields of medicine. OPS 8-550.x had been revised continuously to give a clear structure to quality aspects of geriatric procedures. However, OPS 8-550.x is based on proven need of in-hospital treatment. In the last 10 years, no such definition has been produced taking aspects of the German hospital system into account as well as aspects of transparency and benefit in everyday work. The German DRG system covers just basic reimbursement aspects of geriatric medicine quite well; however, a practicable and patient-oriented definition of "hospital necessity" is still lacking, but is absolutely essential for proper compensation. A further problem concerning geriatric medicine reimbursement in the DRG system is due to the different structures of providing geriatric in-hospital care throughout Germany.

The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care

DEFF Research Database (Denmark)

Nielsen, Marie Germund; Ørnbøl, Eva; Bech, Per

2017-01-01

the web-based MDI in a primary care setting. The validation was based on the Munich-Composite International Diagnostic Interview (M-CIDI) by phone. GPs in the 22 practices in our study included 132 persons suspected of depression. Depression was rated as yes/no according to the MDI and M-CIDI. Sensitivity......BACKGROUND: The Major Depression Inventory (MDI) is widely used in Danish general practice as a screening tool to assess depression in symptomatic patients. Nevertheless, no validation studies of the MDI have been performed. The aim of this study was to validate the web-based version of the MDI...... against a fully structured telephone interview in a population selected on clinical suspicion of depression (ie, presence of two or three core symptoms of depression) in general practice. MATERIALS AND METHODS: General practitioners (GPs) invited consecutive persons suspected of depression to complete...

[Management of malnutrition in geriatric hospital units in Germany].

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Smoliner, C; Volkert, D; Wirth, R

2013-01-01

Elderly hospitalized patients have a high risk for developing malnutrition. The causes for an impaired nutritional status in old age are various and the impact is far-reaching. Malnutrition is a comorbidity that is well treatable and various studies show the favorable effect of nutrition therapy on nutritional status and prognosis. In the past few years, several guidelines have been developed to improve nutritional management and to ensure standardized procedures to identify patients at nutritional risk who will benefit from nutrition therapy. However, it is still not clear to what extent nutrition management has been implemented in geriatric wards in Germany. This survey is intended to give an overview on the situation of the current diagnosis and therapy of malnutrition and nutritional management in geriatric hospital units for acute and rehabilitative care. In 2011, the task force of the German Geriatric Society ("Deutsche Gesellschaft für Geriatrie", DGG) developed a questionnaire which was sent out to 272 directors of geriatric hospital and rehabilitational units. Included were questions regarding the size and staffing of the hospital and wards, food provision, diagnosis and therapy of malnutrition, as well as communication of malnutrition and nutrition therapy in the doctor's letter. A total of 38% of the questioned units answered. The following information was compiled: 31% of the geriatric facilities employed a doctor with training in clinical nutrition, 42% employ dieticians or nutritional scientists, and 90% speech and language pathologists. In 36% of the wards, a so-called geriatric menu is offered (small portions, rich in energy and/or protein, easy to chew). In 89% of the wards, snacks are available between meals. Diagnosis of malnutrition is mainly done by evaluation of weight and BMI. Validated and established screening tools are only used in 40% of the geriatric wards. Food records are carried out in 64% of the units when needed. Diagnosed

Undergraduate Teaching in Geriatrics and Pediatrics in Portuguese Medical Schools: An Observational Study.

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Amaral, Mariana; Matias, Filipa; Massena, Lígia; Cardoso, Nuno

2016-12-30

Motivated by the contracting nature of the Portuguese age pyramid, and thereby the ever increasing geriatric population, the aim of this study was to compare the number of European Credit Transfer and Accumulation System Credits dedicated to Geriatrics with Pediatrics in Portuguese Medical Schools. An observational, descriptive and cross-sectional study was conducted and included six Portuguese Medical Schools that have six years of training and a total of 360 credits. The study plans were obtained from the medical schools' websites or requested. Schools were grouped in modular/classic teaching methodology and the courses were categorized in mandatory/optional and specific/related. The credits of Geriatrics and Pediatrics were compared. Four schools had classical methodology and two had a modular one. Overall, they had more credits dedicated to Pediatrics than Geriatrics. Three schools offered mandatory courses specifically oriented to Geriatrics (1.5 - 8 credits) compared to all schools mandatory courses courses on Pediatrics (5.7 - 26.5 credits). The ratio of averages of mandatory specific courses (Pediatrics/Geriatrics) was 12.4 in the classical and 1.5 in the modular group. Pediatrics teaching has revealed to be superior to Geriatrics in all categories. Based on our results, we consider the Portuguese Geriatrics' undergraduate teaching sub-optimal. Nowadays, geriatric population is quantitatively similar to pediatric population. Efforts should be made to adequate Geriatrics teaching to our reality in order to provide a more adequate health care to this age group.

Exploring the views and experiences of callers to the PANDA Post and Antenatal Depression Association Australian National Perinatal Depression Helpline: a cross-sectional survey.

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Biggs, Laura J; Shafiei, Touran; Forster, Della A; Small, Rhonda; McLachlan, Helen L

2015-09-07

Anxiety and depression are common in the perinatal period. Telephone interventions, including telephone peer support and counselling, have been developed to support those experiencing perinatal mental illness. PANDA Post and Antenatal Depression Association provides support to women and men experiencing perinatal mental illness via the Australian National Perinatal Depression Helpline, encompassing both volunteer peer support and professional counselling. This study aimed to explore the experiences of callers to the Helpline. A cross-sectional survey design was used. All new callers from 1(st) May to 30(th) September 2013 were invited to participate. The survey, adapted from a previous survey of PANDA callers, included 23 questions using Likert-type scales, demographic and open-ended questions. Thematic network analysis was undertaken for responses to open-ended questions. 124 responses were received (124/405; 30% response). The majority of callers had called the Helpline regarding themselves (90%), with over one third (33%) of all callers seeking crisis support and help. Ninety-nine per cent of respondents 'agreed' or 'strongly agreed' that staff and/or volunteers understood their concerns, and 97% 'agreed' or 'strongly agreed' that overall PANDA had helped them. Callers described the PANDA service as uniquely tailored to the perinatal period, providing accessible, non-judgemental understanding and support, with a global theme from open-ended comments describing PANDA as 'a safe space to be heard and receive support without judgement'. Recommendations for service changes included increased hours of availability. Callers reported positive experiences of accessing support from the PANDA National Perinatal Depression Helpline. The Helpline was described as an accessible and acceptable telephone support for individuals experiencing perinatal mental illness. Recommendations for changes to the service included an increase in hours of operation to enable greater

Maintenance of the CERN telephone exchanges

CERN Multimedia

TS Department

2008-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 3 December. During this time, the fixed-line telephone and audio-conference services may be disrupted. However, the CCC and the Fire Brigade will be reachable at all times. Mobile telephone services (GSM) will not be affected by this work. For further details please contact mailto:Netops@cern.ch.

Maintenance of the CERN telephone exchanges

CERN Multimedia

TS Department

2008-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 3 December. During this time, the fixed-line telephone and audio-conference services may be disrupted. However, the CCC and the Fire Brigade will be reachable at all times. Mobile telephone services (GSM) will not be affected by this work. For further details please contact Netops@cern.ch.

COGNITIVE THERAPY DECREASE THE LEVEL OF DEPRESSION

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Ah. Yusuf

2017-07-01

Full Text Available Introduction: Aging is a natural process in individuals. Most of the elderly have problems in dealing with this natural process. Lost of occupation, friends and loneliness may result in depression in this age group. Cognitive therapy changes pessimistic idea, unrealistic hopes and excessive self evaluation may result and justify depression. Cognitive therapy may help elderly to recognize the problem in life, to develop positive objective of life and to create more positive personality. The aimed of this study was to analyze the effect of cognitive therapy to reduce the level of depression. Method: This study was used a pre experimental pre post test design. Sample were 10 elderly people who met to the inclusion criteria. The independent variable was cognitive therapy and dependent variable was the level of depression in elderly. Data were collected by using Geriatric Depression Scale (GDS 15, then analyzed by using Wilcoxon Signed Rank Test with significance levelα≤0.05. Result: The result showed that cognitive therapy has an effect on reducing depression with significance level p=0.005. Discussion: It can be concluded that cognitive therapy was effective in reducing depression level in elderly. Further studies are recommended to analyze the effect of cognitive therapy on decreasing anxiety in elderly by measuring cathecolamin.

Animal-assisted therapy and agitation and depression in nursing home residents with dementia: a matched case-control trial.

Science.gov (United States)

Majić, Tomislav; Gutzmann, Hans; Heinz, Andreas; Lang, Undine E; Rapp, Michael A

2013-11-01

To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F1,48 = 6.43; p <0.05) and depression (F1,48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

[Geriatrics, a form of holistic health care. A bright spot in difficult financial economic times?].

Science.gov (United States)

Dillmann, E B

1984-02-01

Geriatrics has a functional aim, also in a clinical setting; it determines meaningful priorities in the process of diagnosis and treatment of the vulnerable elderly patient and is of a horizontal nature within the other specializations. Additional tasks of geriatrics are the development of adjusted methods for examination and treatment, the pursuing of early onset diagnostics, to supply specific information and the training of geriatric specialists. Clinical geriatric examination should only take place after evaluating the patient in his or her living conditions at home. The patient should thereby fulfil the geriatric trias, that no admission in a nursery home or psychiatric hospital is indicated, that examination at home or at the outpatient department is impossible and that an emergency situation necessitates admission. Ambulantory geriatric care is indispensable for the well functioning of a clinical geriatric department and the two should form an unbreakable tie, which could eventually be transformed into a personal union. A geriatric department in a general hospital is limited in its indications for the admission of geriatric patients, has high operating costs and should be restricted in size per regio, having a minimal capacity of 25 to 30 beds. The geriatric team is broad in composition and strong in coherence. The period of admission of the patient should not exceed six weeks. A regional social-geriatric circuit combines a geriatric department of a general hospital with the ambulantory social-geriatric service, the admission and indication committee of nursing homes into a well tuned system of provisions for the aged.(ABSTRACT TRUNCATED AT 250 WORDS)

Technology for Early Detection of Depression and Anxiety in Older People.

Science.gov (United States)

Andrews, Jacob A; Astell, Arlene J; Brown, Laura J E; Harrison, Robert F; Hawley, Mark S

2017-01-01

Under-diagnosis of depression and anxiety is common in older adults. This project took a mixed methods approach to explore the application of machine learning and technology for early detection of these conditions. Mood measures collected with digital technologies were used to predict depression and anxiety status according to the Geriatric Depression Scale (GDS) and the Hospital Anxiety and Depression Scale (HADS). Interactive group activities and interviews were used to explore views of older adults and healthcare professionals on this approach respectively. The results show good potential for using a machine learning approach with mood data to predict later depression, though prospective results are preliminary. Qualitative findings highlight motivators and barriers to use of mental health technologies, as well as usability issues. If consideration is given to these issues, this approach could allow alerts to be provided to healthcare staff to draw attention to service users who may go on to experience depression.

Cardiopulmonary disease in the geriatric dog and cat

Energy Technology Data Exchange (ETDEWEB)

Miller, M. S.; Tilley, L. P.; Smith, F.W.K. Jr.

1989-01-15

The incidence of cardiopulmonary disease increases with age. Degenerative valvular disease, chronic obstructive pulmonary disease, and arrhythmias are common in the geriatric dog. Chronic bronchial disease, pulmonary neoplasia, and arrhythmias occur in the geriatric cat. Systemic diseases in both species often show cardiopulmonary manifestations. Medical management to treat the underlying disease and to control clinical signs is complicated by altered absorption, metabolism, and elimination of drugs.

Cardiopulmonary disease in the geriatric dog and cat

International Nuclear Information System (INIS)

Miller, M.S.; Tilley, L.P.; Smith, F.W.K. Jr.

1989-01-01

The incidence of cardiopulmonary disease increases with age. Degenerative valvular disease, chronic obstructive pulmonary disease, and arrhythmias are common in the geriatric dog. Chronic bronchial disease, pulmonary neoplasia, and arrhythmias occur in the geriatric cat. Systemic diseases in both species often show cardiopulmonary manifestations. Medical management to treat the underlying disease and to control clinical signs is complicated by altered absorption, metabolism, and elimination of drugs

gerIatrIc ImperatIve

African Journals Online (AJOL)

developments of geriatric medicine in the medical schools and hospitals of Europe .... including physical, mental, social, economic, functional and environmental .... occupational therapy and speech therapy has grown over the years, further ...

Wholistic orthopedics: Is this the right way to treat geriatric orthopedic patients?

OpenAIRE

John Ebnezar; Yogita Bali; Rakesh John

2017-01-01

Geriatric orthopedic problems poses different challenges in their management. Conventional treatment methods like drugs, physiotherapy and surgeries are inadequate. A Geriatric orthopedic patient suffers as a whole and not in isolation. This article highlights the importance of managing geriatric orthopedic patients as a whole and outlines the various steps of wholistic management.

Common geriatric emergencies in a rural hospital in South‑Eastern ...

African Journals Online (AJOL)

Common geriatric emergencies in a rural hospital in South‑Eastern Nigeria. ... by emergency health conditions that predispose them to higher risk of disability and ... The geriatric patients seen within the study period who met the selection ...

Review of fall risk assessment in geriatric populations using inertial sensors

OpenAIRE

Howcroft, Jennifer; Kofman, Jonathan; Lemaire, Edward D

2013-01-01

Background Falls are a prevalent issue in the geriatric population and can result in damaging physical and psychological consequences. Fall risk assessment can provide information to enable appropriate interventions for those at risk of falling. Wearable inertial-sensor-based systems can provide quantitative measures indicative of fall risk in the geriatric population. Methods Forty studies that used inertial sensors to evaluate geriatric fall risk were reviewed and pertinent methodological f...

Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

Science.gov (United States)

Al-Aama, Tareef

2016-06-01

To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population.

Postdoctoral Teaching of Geriatric Dentistry in U.S. Dental Schools.

Science.gov (United States)

Ettinger, Ronald L; Goettsche, Zachary S; Qian, Fang

2017-10-01

The aim of this study was to determine the number and size of postdoctoral teaching programs in geriatric dentistry in U.S. dental schools and other health professions educational institutions and those programs with Health Resources and Services Administration (HRSA) funding. In 2015, all 67 U.S. dental schools were contacted via email with a questionnaire to ask if they had a postdoctoral program in geriatric dentistry; if they did, they were asked to report the length and size of the program. Directors of all 16 HRSA-funded geriatric fellowships were also invited to participate in the survey. Fifty-six of the 67 (83.6%) dental schools and 15 of the 16 (93.8%) HRSA-funded programs completed the questionnaire. Postdoctoral geriatric dentistry programs were reported in 12 dental schools and six medical institutions, although only six programs were currently accepting fellows. The length of the programs was 12-36 months. The maximum number of residents in any program was ten. The oldest program was in Minnesota; it began in 1981. The newest program was beginning in 2017 at Boston University as a revised version of its previous HRSA-funded program. The loss of HRSA funding has had a major negative impact on the number of training programs. Future research is needed to determine how the loss of HRSA-funded programs has affected the availability of educators in geriatric dentistry for dental schools and the services provided to the geriatric community.

Effect of lavender scent inhalation on prevention of stress, anxiety and depression in the postpartum period

Directory of Open Access Journals (Sweden)

Maryam Kianpour

2016-01-01

Full Text Available Background: Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women. Materials and Methods: In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA, and post hoc tests. Level of significance was set as 0.05 for all tests. Results: The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001 and 3 months after delivery (P < 0.0001 were significantly lower in the study group compared with the control group. Conclusions: Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth.

Wholistic orthopedics: Is this the right way to treat geriatric orthopedic patients?

Directory of Open Access Journals (Sweden)

John Ebnezar

2017-01-01

Full Text Available Geriatric orthopedic problems poses different challenges in their management. Conventional treatment methods like drugs, physiotherapy and surgeries are inadequate. A Geriatric orthopedic patient suffers as a whole and not in isolation. This article highlights the importance of managing geriatric orthopedic patients as a whole and outlines the various steps of wholistic management.

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work on the CERN telephone exchanges will be performed on 10 July from 8 p.m. to midnight. During this intervention, the fixed telephone services, audioconference services and GSM calls made via the 333 prefix may be disrupted. However, the CCC and the fire brigade will be reachable at all times. For more details about this maintenance work, please call the telephone switchboard on 76111 or send an e-mail. Telecom SectionIT/CS

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

A maintenance of the CERN telephone exchanges will be performed on the 10th of July from 8 p.m. to midnight. During this intervention, the fixed telephone services, audioconference services, and GSM calls made via the 333 prefix may be disrupted. However, the CCC and the fire brigade will be reachable at any time. For more details about this maintenance, please contact the telephone switchboard at 76111 or by email. Telecom Section IT/CS

Measuring pharmacogenetics in special groups: geriatrics.

Science.gov (United States)

Seripa, Davide; Panza, Francesco; Daragjati, Julia; Paroni, Giulia; Pilotto, Alberto

2015-07-01

The cytochrome P450 (CYP) enzymes oxidize about 80% of the most commonly used drugs. Older patients form a very interesting clinical group in which an increased prevalence of adverse drug reactions (ADRs) and therapeutic failures (TFs) is observed. Might CYP drug metabolism change with age, and justify the differences in drug response observed in a geriatric setting? A complete overview of the CYP pharmacogenetics with a focus on the epigenetic CYP gene regulation by DNA methylation in the context of advancing age, in which DNA methylation might change. Responder phenotypes consist of a continuum spanning from ADRs to TFs, with the best responders at the midpoint. CYP genetics is the basis of this continuum on which environmental and physiological factors act, modeling the phenotype observed in clinical practice. Physiological age-related changes in DNA methylation, the main epigenetic mechanisms regulating gene expression in humans, results in a physiological decrease in CYP gene expression with advancing age. This may be one of the physiological changes that, together with increased drug use, contributed to the higher prevalence of ADRs and TFs observed in the geriatric setting, thus, making geriatrics a special group for pharmacogenetics.

The use of the Modified Telephone Interview for Cognitive Status (TICS-M) in the detection of amnestic mild cognitive impairment.

Science.gov (United States)

Cook, Sarah E; Marsiske, Michael; McCoy, Karin J M

2009-06-01

Many screening tools for detecting cognitive decline require in-person assessment, which is often not cost-effective or feasible for those with physical limitations. The Modified Telephone Interview for Cognitive Status has been used for screening dementia, but little is known about its usefulness in detecting amnestic mild cognitive impairment. Community-dwelling participants (mean age=74.9, mean education = 16.1 years) were administered the Modified Telephone Interview for Cognitive Status during initial screening and subsequently given a multidomain neuropsychological battery. Participants were classified by consensus panel as cognitively normal older adult (noMCI, N=54) or amnestic mild cognitive impairment (N=17) based on neuropsychological performance and Clinical Dementia Rating Scale interview, but independent of Modified Telephone Interview for Cognitive Status score. There was a significant difference between groups in Modified Telephone Interview for Cognitive Status score (t=8.04, PTICS-M alone correctly classified 85.9% of participants into their respective diagnostic classification (sensitivity=82.4%, specificity=87.0%). Receiver operating characteristics analysis resulted in cutoff score of 34 that optimized sensitivity and specificity of amnestic mild cognitive impairment classification. The Modified Telephone Interview for Cognitive Status is a brief, cost-effective screening measure for identifying those with and without amnestic mild cognitive impairment.

The Effect of Pet Therapy on Depression of Elderly Resident in Nursing Homes

Directory of Open Access Journals (Sweden)

Shima Daliriyan

2014-07-01

Full Text Available Objectives: In old age depression is common problem. Its rate at elderly residing at nursing homes is 30-50%. Several types of medications are used to treat depression. However because elderly use many drugs due to their numerous problems, non pharmacological methods such as pet therapy can be considered. So the present study intended to assess the effectiveness of pet therapy on elderly depression.  Methods & Materials: A quasi-experimental study was conducted with 60 elderly living at nursing homes. The elderly were randomly placed at two groups: intervention group (N:29 and control group (N:31. In both groups Geriatric Depression Scale (GDS and a questionnaire for demographic characteristics were used to collect data. Then research intervention including animal care program over a six-week period was performed. And the control group did not receive this intervention. Both groups were assessed by The Geriatric Depression Scale after the intervention period. Pretest score and posttest score were compared. To analyze the collected data Chi-square and independent t-test were used and the dependant t-test was applied to analyze the variables. Results: Findings of this study showed that depression of elderly of intervention group decreased from 8/55 before intervention to 4.79 after intervention (P<0.001. But no significant difference was observed in the control group. The comparison of depression scores mean in both groups before intervention shows no significant statistical difference (P=0.531 while the mean after the intervention in control group was significantly higher (P=0.001.  Conclusion: Considering the results of this study, it can be suggested that pet therapy has positive effects on reduction of elderly depression. Therefore, non-invasion interventions such as keeping pet by nurses can improve elderly depression and can cause their active participation. It is strongly recommended to use this intervention widely at nursing homes. In

Group interpersonal and social rhythm therapy for bipolar depression.

Science.gov (United States)

Hoberg, Astrid A; Ponto, Julie; Nelson, Pamela J; Frye, Mark A

2013-10-01

To evaluate the feasibility of 2-week interpersonal and social rhythm therapy group (IPSRT-G) for bipolar depression. Participants with bipolar depression received two individual sessions, six IPSRT-G sessions, and a 12-week telephone call. The Inventory of Depressive Symptomatology-Clinician Rated (IDS-C), Young Mania Rating Scale (YMRS), Sheehan Disability Scale (SDS), and Clinical Global Impressions-Bipolar Version (CGI-BP) were used. IDS-C and SDS scores improved significantly at 12 weeks. YMRS and CGI-BP scores improved but did not reach statistical significance. The promising antidepressive response supports further study of IPSRT-G for bipolar depression. © 2013 Wiley Periodicals, Inc.

MEMORY SONGS DECREASE DEPRESSION FOR STROKE PATIENTS

Directory of Open Access Journals (Sweden)

Harmayetty Harmayetty

2017-07-01

Full Text Available Introduction: Biological, physical and phsycosocial changes in stroke patient could be a stressor that induced a depression state. There would be an emotional disturbance in stroke patient and stroke attack would be recurrent, if it was not treated. One of the alternative techniques to reduce depression is musical therapy especially memory songs. Method: This study was used a quasy experimental pre-post test purposive sampling design. The population was stroke patients who treated in Neurological Ward A and Stroke Unit Dr Soetomo Hospital Surabaya. There were 12 respondents divided into 6 respondents for treatment group and 6 respondents for control group. The independent variable was music (memory song and dependent variable was depression. Data were collected by using questionnaire which adapted from Hamilton Depression Rating Scale and Geriatric Depression Rating Scale, then analyzed by using Wilcoxon Signed Rank Test and Mann Whitney U Test with significance level α≤0.05. Result: The result showed that there was a difference between pre test and post test in depression (p=0.0196 and there was a difference in the depression between treatment group and control group (p=0.002. Discussion: It can be concluded that music (memory songs has an effect to the depression of stroke patient. Further studies are needed to concerning other factors that may affect the relaxation technique especially in listening music.

Patient-Centered Technological Assessment and Monitoring of Depression for Low-Income Patients

OpenAIRE

Wu, Shinyi; Vidyanti, Irene; Liu, Pai; Hawkins, Caitlin; Ramirez, Magaly; Guterman, Jeffrey; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Ell, Kathleen

2014-01-01

Depression is a significant challenge for ambulatory care because it worsens health status and outcomes, increases health care utilizations and costs, and elevates suicide risk. An automatic telephonic assessment (ATA) system that links with tasks and alerts to providers may improve quality of depression care and increase provider productivity. We used ATA system in a trial to assess and monitor depressive symptoms of 444 safety-net primary care patients with diabetes. We assessed system prop...

Geriatric dentistry content in the curriculum of the dental schools in Chile.

Science.gov (United States)

León, Soraya; Araya-Bustos, Francisca; Ettinger, Ronald L; Giacaman, Rodrigo A

2016-09-01

The purpose of this study was to identify the status of pre-doctoral geriatric dentistry education among all Chilean dental schools. Chile is one of the most rapidly ageing countries in Latin America. Consequently, specific knowledge and training on the needs of elderly populations need to be emphasised in dental schools. The current extent and methods of teaching geriatric dentistry among the dental schools in Chile are unknown. A web-based questionnaire was developed and sent to all 19 Chilean dental schools to identify which schools had a formal programme on geriatric dentistry and ask about their format, content and type of training of the faculty who taught in the programmes. Data were analysed, and a comparison was made among the schools. Sixteen (84%) of the participant schools reported teaching at least some aspects of geriatric dentistry, using various methodologies, but only 7 (37%) had specific courses. Of those schools reporting a didactic content on geriatric dentistry, 71% included clinical training, either in the school's dental clinics or in an extramural service. Contents mostly included demographics of ageing, theories of ageing and medical conditions. More than half of the faculty (57%) stated that they had formal training in geriatric dentistry, 43% were trained in prosthodontics, public health or other areas. Although most dental schools taught geriatric dentistry, only some had a specific course. Most schools with formal courses followed the international curriculum guidelines for geriatric dentistry. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Humanities and Geriatric Education: a Strategy for Recruitment?

Science.gov (United States)

Frank, Christopher; Martin, Ruth Elwood

2015-01-01

Ageing is a common subject in arts and literature as it is a universal experience. The use of the humanities in medical education may have a positive effect on trainees’ attitude to caring for seniors and on geriatrics as a career choice. This paper summarizes the role of humanities in medical education and provides some examples and thoughts on how humanities curriculum can be used in geriatric teaching. PMID:25825611

[Antibiotic prescription usage and assessment in geriatric patients].

Science.gov (United States)

Dinh, Aurélien; Davido, Benjamin; Salomon, Jérôme; Le Quintrec, Jean-Laurent; Teillet, Laurent

2016-01-01

Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Geriatric Rehabilitation Patients’ Perceptions of Unit Dining Locations

OpenAIRE

Baptiste, Françoise; Egan, Mary; Dubouloz-Wilner, Claire-Jehanne

2014-01-01

Background Eating together is promoted among hospitalized seniors to improve their nutrition. This study aimed to understand geriatric patients’ perceptions regarding meals in a common dining area versus at the bedside. Methods An exploratory qualitative study was conducted. Open-ended questions were asked of eight patients recruited from a geriatric rehabilitation unit where patients had a choice of meal location. Results Eating location was influenced by compliance with the perceived rules ...

Is It safe? Nonoperative management of blunt splenic injuries in geriatric trauma patients.

Science.gov (United States)

Trust, Marc D; Teixeira, Pedro G; Brown, Lawrence H; Ali, Sadia; Coopwood, Ben; Aydelotte, Jayson D; Brown, Carlos V R

2018-01-01

Because of increased failure rates of nonoperative management (NOM) of blunt splenic injuries (BSI) in the geriatric population, dogma dictated that this management was unacceptable. Recently, there has been an increased use of this treatment strategy in the geriatric population. However, published data assessing the safety of NOM of BSI in this population is conflicting, and well-powered multicenter data are lacking. We performed a retrospective analysis of data from the National Trauma Data Bank (NTDB) from 2014 and identified young (age < 65) and geriatric (age ≥ 65) patients with a BSI. Patients who underwent splenectomy within 6 hours of admission were excluded from the analysis. Outcomes were failure of NOM and mortality. We identified 18,917 total patients with a BSI, 2,240 (12%) geriatric patients and 16,677 (88%) young patients. Geriatric patients failed NOM more often than younger patients (6% vs. 4%, p < 0.0001). On logistic regression analysis, Injury Severity Score of 16 or higher was the only independent risk factor associated with failure of NOM in geriatric patients (odds ratio, 2.778; confidence interval, 1.769-4.363; p < 0.0001). There was no difference in mortality in geriatric patients who had successful vs. failed NOM (11% vs. 15%; p = 0.22). Independent risk factors for mortality in geriatric patients included admission hypotension, Injury Severity Score of 16 or higher, Glasgow Coma Scale score of 8 or less, and cardiac disease. However, failure of NOM was not independently associated with mortality (odds ratio, 1.429; confidence interval, 0.776-2.625; p = 0.25). Compared with younger patients, geriatric patients had a higher but comparable rate of failed NOM of BSI, and failure rates are lower than previously reported. Failure of NOM in geriatric patients is not an independent risk factor for mortality. Based on our results, NOM of BSI in geriatric patients is safe. Therapeutic, level IV.

[Rehabilitation for musculoskeltal disorders in geriatric patients].

Science.gov (United States)

Shirado, O

1997-07-01

Aging is typically accompanied by gradual but progressive physiological changes and an increased prevalence of acute and chronic illness in any organs. Musculoskeltal system is one of the most involved organs in geriatric patients. Appropriate roles in geriatric rehabilitation for musculoskeltal disorders should be emphasized not only to treat the disorders, but also to prevent many complications cause by specific disease or injury. Representative management methods in geriatric rehabilitation are introduced in this section. Rest is often effective, especially in the acute phase of illness or injury. However, cautions should be paid in disuse syndrome which may be produced by prolonged bed rest. Major manifestations in this syndrome includes muscle weakness and atrophy, joint contracture, decubitus, osteoporosis, ectopic ossification, cardiovascular impairment, pneumonia, urological and mental problems. Physical agents such as heat, cold, light and pressure have been used as therapeutic agents. Electrical stimulation is often effective in the treatment of low-back pain syndrome. Traction is the act of drawing, or a pulling force. Its mechanism to relieve pain seems to immobilize the injured parts, to increase peripheral circulation by massage effect and to improve muscle spasm. Brace is very effective to control acute pain in musculoskeltal system. However, long-term wear of brace should be avoided to prevent the disuse syndrome. Exercise is one of the most important rehabilitation modalities. This includes stretching and muscle strengthening programs. Education of body mechanism in activity of daily living is essential in rehabilitation of geriatric patients.

Maintenance of the telephone exchange in building 40

CERN Multimedia

2006-01-01

In order to secure the power supply of the telephone exchange in Building 40, maintenance work will be done on 18th December from 7.30 am to 8 am. During this intervention, the fixed telephone services in Building 39 and 40 will be interrupted. The fixed telephone services in other CERN buildings will not be affected by this maintenance. The mobile telephone services (GSM) will not be affected. For more details, please send your questions to Standard.Telephone@cern.ch Telecom Services IT/CS

Doctor-patient communication on the telephone.

Science.gov (United States)

Curtis, P; Evens, S

1989-01-01

Since its invention, the telephone has been an important tool in medical practice, particularly for primary care physicians. Approximately half the calls made to a physician's office during regular consulting hours are for clinical problems and most are handled effectively over the phone without an immediate office visit. Telephone encounters are generally very brief, and managing such calls requires a pragmatic approach that is often quite different from the approach taken in the office visit. The telephone encounter should be recognized and recorded as a specific medical interaction in the medical chart for both clinical and legal reasons. Effective telephone encounters depend on good communication skills; decision making regarding disposition is a major goal. The physician's perception of a medical problem may be different from the patient's; patients are frequently seeking advice and reassurance rather than diagnosis and treatment, and may call because of anxiety and psychological stress. For physicians and their families who are not prepared for after-hours telephone encounters, calls that interrupt more "legitimate" activities may result in anger or frustration for the physician and dissatisfaction for the patient.

Teaching geriatric medicine at the Queen's University of Belfast.

Science.gov (United States)

Stout, R W

1983-01-01

Undergraduate teaching at the Queen's University, Belfast, takes place in the fourth year of a five year curriculum. It lasts three weeks and this is divided into two parts. First, held within the university department, is topic-based teaching including seminars, discussions, case histories and visits. The second phase of two weeks consists of attachment of two to four students to geriatric medical units both in and outside Belfast. The whole of this module is situated within a combined course involving community medicine, general practice, geriatric medicine and mental health lasting 12 weeks and involving one-third of the year of 150 students each time. In addition to the three weeks teaching in geriatrics, joint discussion groups are held.

Common geriatric emergencies in a rural hospital in South-Eastern ...

African Journals Online (AJOL)

2011-11-02

Nov 2, 2011 ... epidemiologically recognized as constitutional risk factor ... Materials and Methods: This was a descriptive hospital-based study of 216 geriatric patients who .... (hypertension and hypertension-related heart failure) the ... [7,8] This finding has ... measured with sphygmomanometer, majority of geriatric.

[Specialties in dentistry. 4. Post-academic specialization in geriatric dentistry

NARCIS (Netherlands)

Schaub, R.M.; Baat, C. de

2006-01-01

In recent years, a specialization in geriatric dentistry has been established and along with it an educational programme. A specialist in geriatric dentistry is a dentist general practitioner with special knowledge and skills for delivering oral care to frail elderly people. The educational

Specialties in dentistry. 4. Post-academic specialization in geriatric dentistry

NARCIS (Netherlands)

Schaub, R.M.; de Baat, C.

2006-01-01

In recent years, a specialization in geriatric dentistry has been established and along with it an educational programme. A specialist in geriatric dentistry is a dentist general practitioner with special knowledge and skills for delivering oral care to frail elderly people. The educational

Atypical antipsychotics as add-on treatment in late-life depression

Directory of Open Access Journals (Sweden)

Cakir S

2016-09-01

Full Text Available Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study.Methods: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results: Thirty-five patients were screened: 21 (60% had quetiapine, twelve (34.28% had aripiprazole, and two (5.71% had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02. Of the 35 patients, 23 (65.7% patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion: This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. Keywords: treatment resistance, aripiprazole

Direct Costs of Very Old Persons with Subsyndromal Depression: A 5-Year Prospective Study.

Science.gov (United States)

Ludvigsson, Mikael; Bernfort, Lars; Marcusson, Jan; Wressle, Ewa; Milberg, Anna

2018-03-15

This study aimed to compare, over a 5-year period, the prospective direct healthcare costs and service utilization of persons with subsyndromal depression (SSD) and non-depressive persons (ND), in a population of very old persons. A second aim was to develop a model that predicts direct healthcare costs in very old persons with SSD. A prospective population-based study was undertaken on 85-year-old persons in Sweden. Depressiveness was screened with the Geriatric Depression Scale at baseline and at 1-year follow-up, and the results were classified into ND, SSD, and syndromal depression. Data on individual healthcare costs and service use from a 5-year period were derived from national database registers. Direct costs were compared between categories using Mann-Whitney U tests, and a prediction model was identified with linear regression. For persons with SSD, the direct healthcare costs per month of survival exceeded those of persons with ND by a ratio 1.45 (€634 versus €436), a difference that was significant even after controlling for somatic multimorbidity. The final regression model consisted of five independent variables predicting direct healthcare costs: male sex, activities of daily living functions, loneliness, presence of SSD, and somatic multimorbidity. SSD among very old persons is associated with increased direct healthcare costs independently of somatic multimorbidity. The associations between SSD, somatic multimorbidity, and healthcare costs in the very old need to be analyzed further in order to better guide allocation of resources in health policy. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

7 CFR 1737.60 - Telephone loan budget.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Telephone loan budget. 1737.60 Section 1737.60... Cost Estimation Procedures § 1737.60 Telephone loan budget. (a) RUS shall prepare a “Telephone Loan Budget” (RUS Form 493) showing all costs for the proposed project and the amount of loan and nonloan...

Teaching Programs in Geriatric Optometry.

Science.gov (United States)

Rosenbloom, Albert A.

1985-01-01

Results of a survey of U.S. and Canadian optometry programs concerning curriculum design, clinical and residency training programs, continuing education, and research projects planned or under way in geriatric optometry are presented and discussed. (MSE)

Perceptions, attitudes, and experiences of hematology/oncology fellows toward incorporating geriatrics in their training.

Science.gov (United States)

Maggiore, Ronald J; Gorawara-Bhat, Rita; Levine, Stacie K; Dale, William

2014-01-01

The aging of the U.S. population continues to highlight emerging issues in providing care generally for older adults and specifically for older adults with cancer. The majority of patients with cancer in the U.S. are currently 65 years of age or older; therefore, training and research in geriatrics and geriatric oncology are viewed to be integral in meeting the needs of this vulnerable population. Yet, the ways to develop and integrate best geriatrics training within the context of hematology/oncology fellowship remain unclear. Toward this end, the current study seeks to evaluate the prior and current geriatric experiences and perspectives of hematology/oncology fellows. To gain insight into these experiences, focus groups of hematology/oncology fellows were conducted. Emergent themes included: 1) perceived lack of formal geriatric oncology didactics among fellows; 2) a considerable amount of variability exists in pre-fellowship geriatric experiences; 3) shared desire to participate in a geriatric oncology-based clinic; 4) differences across training levels in confidence in managing older adults with cancer; and 5) identification of specific criteria on how best to approach older adults with cancer in a particular clinical scenario. The present findings will help guide future studies in evaluating geriatrics among hematology/oncology fellows across institutions. They will also have implications in the development of geriatrics curricula and competencies specific to hematology/oncology training. © 2013.

Depressive symptoms and depression in people screened positive for dementia in primary care - results of the DelpHi-study.

Science.gov (United States)

Thyrian, Jochen René; Eichler, Tilly; Reimann, Melanie; Wucherer, Diana; Dreier, Adina; Michalowsky, Bernhard; Hoffmann, Wolfgang

2016-06-01

Dementia and depression are common syndromes in the elderly. There is lack of knowledge concerning the frequency of depressive symptoms in people with dementia (PWD) and factors associated with depression. The aim of this analysis is to (a) describe the frequency of depressive symptoms in people screened positive for dementia, (b) describe differences between PWD with and without depressive symptoms, and (c) analyze associations between depressive symptoms and other dementia-related variables. Analyses are based on data of the GP-based intervention trial DelpHi-MV. A sample of 430 (6.29%) people screened positive for dementia in primary care was analyzed regarding depression according to the German version of the Geriatric Depression Scale (GDS, 15-items), demographic variables, and dementia/depression-related variables. Multivariate analyses were conducted to identify factors associated with depressive symptoms. The mean GDS-score of depressive symptoms in n = 430 PWD was m = 3.21 (SD 2.45) with 67 PWD (15.55%) showing clinically relevant depression (GDS depression and n = 62 (14.42%) received antidepressive drug treatment. Depressive symptoms are significantly associated with age (OR = 0.93), functional impairment (OR = 1.36), and quality of life (OR = 0.01, CI: 0.00-0.06). Our results support previous findings that clinically relevant depressive symptoms are more common in people screened positive for dementia than in the general population and are often missed or mismanaged. Our findings underline the importance of managing quality of life, functional status, or depressive symptoms. Also, the results highlight the benefit of including the partner (and probably other carers) for adequate treatment of PWD.

Barriers and facilitators of treatment for depression in a latino community: a focus group study.

Science.gov (United States)

Uebelacker, Lisa A; Marootian, Beth A; Pirraglia, Paul A; Primack, Jennifer; Tigue, Patrick M; Haggarty, Ryan; Velazquez, Lavinia; Bowdoin, Jennifer J; Kalibatseva, Zornitsa; Miller, Ivan W

2012-02-01

We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 20 November. Fixed-line telephone and audioconference services may be disrupted while the work is being carried out. However, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. For further details about the maintenance work, please contact the telephone switchboard on 76111 or by email. Telecom Section - IT/CS

[Can I have some sunshine to cheer me up? vitamin D deficiency and depression in the elderly].

Science.gov (United States)

Stalpers-Konijnenburg, S C; Marijnissen, R M; Gaasbeek, A B; Oude Voshaar, R C

2011-01-01

Vitamin D deficiency is very common in the elderly, and the geriatric patient is probably at even greater risk. Vitamin D plays an important role in calcium homeostasis; recent studies point to a possible causal link between vitamin D deficiency and the development and severity of depression. In this article we focus on an 80-year-old patient with depression and severe vitamin D deficiency and give advice on the diagnosis and treatment of vitamin D deficiency. To supplement the current multidisciplinary guidelines on depression, we recommend routine testing of serum vitamin D level prior to confirming the diagnosis of depression in the elderly.

Prospective Evaluation of Pretreatment Executive Cognitive Impairment and Depression in Patients Referred for Radiotherapy

International Nuclear Information System (INIS)

Fuller, Clifton D.; Schillerstrom, Jason E.; Jones, William E.; Boersma, Melissa; Royall, Donald R.; Fuss, Martin

2008-01-01

Purpose: Cancer patients are at risk of cognitive impairment and depression. We sought to ascertain the prevalence of executive, visuospatial, memory, and general cognitive performance deficits before radiotherapy in a radiation oncology clinic referral population and correlate the neurocognitive measures with the depression symptom burden. Methods and Materials: A total of 122 sequential patients referred for radiotherapy evaluation were administered a test battery composed of the Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX1 and CLOX2), Mini Mental State Examination (MMSE), Memory Impairment Screen (MIS), and Geriatric Depression Scale (GDS). The mean age ± standard deviation was 58 ± 17 years. Of 122 patients, 24 (20%) had been referred for breast cancer, 21 (17%) for gastrointestinal cancer, 17 (14%) for genitourinary disease, and 8 (7%) for brain lesions; the rest were a variety of tumor sites. The cognitive performance among the tumor cohorts was compared using Bonferroni-corrected analysis of variance and Tukey-Kramer tests. Pearson correlation coefficients were determined between each cognitive instrument and the GDS. Results: Of the 122 patients, 52 (43%) exhibited a detectable executive cognition decrement on one or more test measures. Five percent had poor memory performance (MIS), 18% had poor visuospatial performance (CLOX2), and 13% had poor global cognition (MMSE). Patients with brain tumors performed substantially worse on the EXIT25. No between-group differences were found for CLOX1, CLOX2, MIS, or GDS performance. The EXIT25 scores correlated significantly with the GDS scores (r = 0.26, p = 0.005). Conclusions: The results of this study have shown that patients referred for radiotherapy exhibit cognitive impairment profiles comparable to those observed in acutely ill medical inpatients. Executive control impairment appears more prevalent than global cognitive deficits, visuospatial impairment, or depression

Structured reminiscence: an intervention to decrease depression and increase self-transcendence in older women.

Science.gov (United States)

Stinson, Cynthia Kellam; Kirk, Edythe

2006-02-01

The purpose of this study was to assess the effect of group reminiscing on depression and self-transcendence of older women residing in an assisted living facility in southeast Texas. There were two major objectives for this study. One objective was to determine if depression decreased in older women after structured reminiscence group sessions held twice weekly for a six-week period. A second objective was to determine if self-transcendence increased after structured reminiscence group sessions held twice weekly for a six-week period. Reminiscence has been studied to determine its impact on a variety of conditions including but not limited to depression, self-esteem, fatigue, isolation, socialization, well-being, language acquisition and cognitive functioning. This review of research specifically focused on reminiscence, depression, self-transcendence and older people. Two groups were assessed at baseline, three and six weeks to answer the research questions. A sample of 24 women between the ages of 72 and 96 years were randomly assigned to either a reminiscence (experimental) group or the activity (control) group of the facility. Pearson's r was used to determine the magnitude of the relationship between subjects' responses on the Geriatric Depression Scale and the Self-Transcendence Scale. A mixed design analysis of variance (anova) was used to determine if there was a difference between the experimental and control groups on scores of the Geriatric Depression Scale and the Self-Transcendence Scale at baseline, three and six weeks. Data revealed a non-significant decrease in depression and increase in self-transcendence in the reminiscence group at the completion of six weeks, indicating a trend toward a positive result with reminiscence group sessions. The study also revealed an inverse relationship between depression and self-transcendence. These findings underscore the importance of screening older people for depression. One of the primary modalities used for

Adolescent Depressed Mood and Parental Unhappiness.

Science.gov (United States)

Lasko, David S.; And Others

1996-01-01

A set of self-report scales on depression, parental happiness, intimacy, social support, self-esteem, and risk-taking behavior was administered to 455 adolescents to determine the role of depression with the other variables. Depressed adolescents were found to be less intimate with parents, felt less social support, and had lower self-esteem.…